Provider Demographics
NPI:1710287222
Name:MORTON, MELINDA LEE (SLP)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:LEE
Last Name:MORTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:MELINDA
Other - Middle Name:LEE MORTON
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:1112 N FLOYD RD
Mailing Address - Street 2:#9
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4243
Mailing Address - Country:US
Mailing Address - Phone:972-470-5855
Mailing Address - Fax:
Practice Address - Street 1:1112 N FLOYD RD
Practice Address - Street 2:#9
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4243
Practice Address - Country:US
Practice Address - Phone:972-470-5855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-31
Last Update Date:2010-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102870235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist