Healthcare Provider Details

I. General information

NPI: 1578411278
Provider Name (Legal Business Name): LAURA MELENDREZ MA., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 HILLRISE CIR
LAS CRUCES NM
88011-4759
US

IV. Provider business mailing address

1350 HILLRISE CIR
LAS CRUCES NM
88011-4759
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-9500
  • Fax: 575-523-1108
Mailing address:
  • Phone: 575-522-9500
  • Fax: 575-523-1108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2026-0064
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: