Healthcare Provider Details

I. General information

NPI: 1346161916
Provider Name (Legal Business Name): AUTUMN MELINO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 DORADO CT
HIGH POINT NC
27265-9650
US

IV. Provider business mailing address

408 DORADO CT
HIGH POINT NC
27265-9650
US

V. Phone/Fax

Practice location:
  • Phone: 828-551-1960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12010
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: