Healthcare Provider Details

I. General information

NPI: 1942849245
Provider Name (Legal Business Name): MELANIE ZOOK M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 OFFICE PARK DR
JACKSONVILLE NC
28546-3218
US

IV. Provider business mailing address

206 HOLLY POND DR
HOLLY RIDGE NC
28445-8823
US

V. Phone/Fax

Practice location:
  • Phone: 910-353-2440
  • Fax:
Mailing address:
  • Phone: 949-878-1873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30001482
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: