Provider Demographics
NPI:1760655070
Name:TRAYLOR, MELODY A (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:A
Last Name:TRAYLOR
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43603 W KRAMER LN
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85238-8937
Mailing Address - Country:US
Mailing Address - Phone:520-568-6701
Mailing Address - Fax:
Practice Address - Street 1:43603 W KRAMER LN
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85238-8937
Practice Address - Country:US
Practice Address - Phone:520-568-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4685235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist