Healthcare Provider Details

I. General information

NPI: 1194971754
Provider Name (Legal Business Name): MRS. MELINDA MENDZEF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HIGHWAY 64 EAST
ALMA AR
72921
US

IV. Provider business mailing address

3425 GOLF COURSE DR
ALMA AR
72921-8605
US

V. Phone/Fax

Practice location:
  • Phone: 479-632-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP#2481
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: