Provider Demographics
NPI:1871930883
Name:CHATELAIN, MELISSA K (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:CHATELAIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:KOHLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1506 MACON DR
Mailing Address - Street 2:SUITE B3
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-1849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1506 MACON DR
Practice Address - Street 2:SUITE B3
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-1849
Practice Address - Country:US
Practice Address - Phone:501-223-9260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#3229235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist