Provider Demographics
NPI:1245960277
Name:MELL, MORGAN LYNN
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LYNN
Last Name:MELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 OLD BALLWIN RD
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-4818
Mailing Address - Country:US
Mailing Address - Phone:618-977-3627
Mailing Address - Fax:
Practice Address - Street 1:1800 1ST CAPITOL DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-1646
Practice Address - Country:US
Practice Address - Phone:636-425-3055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist