Provider Demographics
NPI:1942874888
Name:YETTER, MELANIE ANNE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ANNE
Last Name:YETTER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 ARBOR CREST RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7058
Mailing Address - Country:US
Mailing Address - Phone:405-308-1249
Mailing Address - Fax:
Practice Address - Street 1:721 HOLLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9033
Practice Address - Country:US
Practice Address - Phone:919-762-7175
Practice Address - Fax:984-225-2324
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13119235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty