Provider Demographics
NPI:1396875928
Name:CHIN, MELANIE ELIZABETH (SLP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ELIZABETH
Last Name:CHIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 NW 111TH TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-2268
Mailing Address - Country:US
Mailing Address - Phone:954-430-9396
Mailing Address - Fax:954-430-9396
Practice Address - Street 1:2111 NW 111TH TER
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-2268
Practice Address - Country:US
Practice Address - Phone:954-430-9396
Practice Address - Fax:954-430-9396
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ3337235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist