Provider Demographics
NPI:1891966339
Name:DUNCAN, MELISSA BETH (AUD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:BETH
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3729
Mailing Address - Country:US
Mailing Address - Phone:501-315-7620
Mailing Address - Fax:501-315-7695
Practice Address - Street 1:5 MEDICAL PARK DR
Practice Address - Street 2:SUITE 203
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3729
Practice Address - Country:US
Practice Address - Phone:501-315-7620
Practice Address - Fax:501-315-7695
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA#232231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1891966339Medicaid
AR1891966339Medicaid