Provider Demographics
NPI:1669685566
Name:TAYLOR, MELINDA J (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:J
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:J
Other - Last Name:MCARTHUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1013 PROSPECT ST
Mailing Address - Street 2:APT 1211
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-3480
Mailing Address - Country:US
Mailing Address - Phone:801-573-5589
Mailing Address - Fax:
Practice Address - Street 1:575 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2001
Practice Address - Country:US
Practice Address - Phone:808-674-9262
Practice Address - Fax:808-674-8481
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISP-885235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist