Healthcare Provider Details

I. General information

NPI: 1245284413
Provider Name (Legal Business Name): MELANIE L HOUK CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BALL STATE UNIVERSITY SPEECH-LANGUAGE CLINIC AC 104
MUNCIE IN
47306-0001
US

IV. Provider business mailing address

2205 S PERSHING DR
MUNCIE IN
47302-4258
US

V. Phone/Fax

Practice location:
  • Phone: 765-285-8170
  • Fax:
Mailing address:
  • Phone: 765-285-8170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22001560
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: