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NPI Code Detail

MEDICARE: MRS. MELISSA D CAVENDER M.ED. CCC-SLP

MEDICARE: MRS. MELISSA D CAVENDER M.ED. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist09147976CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043362783
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA D CAVENDER M.ED. CCC-SLP
Provider Business Mailing Address
First Line : 2015 N FRANKLIN ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-7120
Country : US
Telephone Number : 719-641-5325
Fax Number :
Provider Business Practice Location Address
First Line : 2015 N FRANKLIN ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-7120
Country : US
Telephone Number : 719-641-5325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 07/08/2007

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