Provider Demographics
NPI:1336345388
Name:SCHULDT, MELINDA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:SCHULDT
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 1:730 MARY ANN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-2228
Mailing Address - Country:US
Mailing Address - Phone:815-505-0595
Mailing Address - Fax:
Practice Address - Street 1:730 MARY ANN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-2228
Practice Address - Country:US
Practice Address - Phone:815-505-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist