Provider Demographics
NPI:1356900237
Name:MEHLMAN, VANESSA (HIS)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:MEHLMAN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 G ST
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-3913
Mailing Address - Country:US
Mailing Address - Phone:501-743-5654
Mailing Address - Fax:
Practice Address - Street 1:8 G ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3913
Practice Address - Country:US
Practice Address - Phone:501-743-5654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR654237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist