Provider Demographics
NPI:1639362551
Name:BIGTHUMB, MELVINA E (MS)
Entity Type:Individual
Prefix:
First Name:MELVINA
Middle Name:E
Last Name:BIGTHUMB
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:ST MICHAELS
Mailing Address - State:AZ
Mailing Address - Zip Code:86511-0100
Mailing Address - Country:US
Mailing Address - Phone:928-871-2822
Mailing Address - Fax:928-871-2837
Practice Address - Street 1:MUSTANG RD. 1 MI. N. OF HIGHWAY 264
Practice Address - Street 2:
Practice Address - City:ST MICHAELS
Practice Address - State:AZ
Practice Address - Zip Code:86511-0100
Practice Address - Country:US
Practice Address - Phone:928-871-2822
Practice Address - Fax:928-871-2837
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant