Provider Demographics
NPI:1639234453
Name:KESSINGER, MELODY ANN (MS, CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:ANN
Last Name:KESSINGER
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4042 S. HILLCREST
Mailing Address - Street 2:APT. A105
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807
Mailing Address - Country:US
Mailing Address - Phone:417-523-3171
Mailing Address - Fax:
Practice Address - Street 1:415 S GOLDEN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-4709
Practice Address - Country:US
Practice Address - Phone:417-523-3171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006019906235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist