Provider Demographics
NPI:1740741685
Name:BANAYAN, MELODY TERMECHI (MS)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:TERMECHI
Last Name:BANAYAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:
Other - Last Name:TERMECHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2265 S BEVERLY GLEN BLVD APT 407
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2453
Mailing Address - Country:US
Mailing Address - Phone:310-913-2401
Mailing Address - Fax:
Practice Address - Street 1:2265 S BEVERLY GLEN BLVD APT 407
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-2453
Practice Address - Country:US
Practice Address - Phone:310-913-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist