Provider Demographics
NPI:1912234899
Name:POTTS, MELODY NAIR (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:NAIR
Last Name:POTTS
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:P.O. BOX 51
Mailing Address - Street 2:4932 BLACK BEAR CT.
Mailing Address - City:MESA
Mailing Address - State:CO
Mailing Address - Zip Code:81643-0051
Mailing Address - Country:US
Mailing Address - Phone:970-268-5001
Mailing Address - Fax:
Practice Address - Street 1:2121 NORTH AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6428
Practice Address - Country:US
Practice Address - Phone:970-244-1319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist