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General NPI Number Information
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NPI Number | 1083840334
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Entity Type | Organization
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Legal Business Name | MELANIE E. CANADA
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 69 DEANE RD
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City | RUCKERSVILLE
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State | VA
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Zip | 22968-3482
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Country | US
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Telephone | 434-481-3524
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Fax | 434-481-3628
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Provider Business Mailing Address
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Address Line | 69 DEANE RD
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City | RUCKERSVILLE
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State | VA
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Zip | 22968-3482
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Country | US
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Telephone | 434-481-3524
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Fax | 434-481-3628
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. MELANIE E. CANADA
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Credential | MS, CCC-SLP
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Telephone | 434-481-3524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202004167
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License Number State | VA
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