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General NPI Number Information
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NPI Number | 1093728032
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Entity Type | Individual
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Provider Name | MELANIE PERREAULT MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 16750 W GARFIELD ST
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City | GOODYEAR
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State | AZ
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Zip | 85338-6287
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Country | US
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Telephone | 623-772-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 24830 W DOVE TRL
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City | BUCKEYE
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State | AZ
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Zip | 85326-1768
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Country | US
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Telephone | 623-327-9720
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SLP4352
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License Number State | AZ
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