Healthcare Provider Details

I. General information

NPI: 1871725481
Provider Name (Legal Business Name): MELISSA ERIN COE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2009
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5607 LAKE LINDERO DR
AGOURA HILLS CA
91301-1951
US

IV. Provider business mailing address

5607 LAKE LINDERO DR
AGOURA HILLS CA
91301-1951
US

V. Phone/Fax

Practice location:
  • Phone: 407-595-4401
  • Fax:
Mailing address:
  • Phone: 407-595-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP24782
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: