Provider Demographics
NPI:1467738419
Name:STINNETT, MELANIE LORA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:LORA
Last Name:STINNETT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2864 S NETTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5970
Mailing Address - Country:US
Mailing Address - Phone:417-324-7607
Mailing Address - Fax:417-708-0889
Practice Address - Street 1:2864 S NETTLETON AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5970
Practice Address - Country:US
Practice Address - Phone:417-324-7607
Practice Address - Fax:417-708-0889
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011017828235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist