NPI Code Detail JSON Logo

1205967577 NPI number — LESLEY MELLOR M.S. CCC-SP

NPI Number: 1205967577
Health Care Provider/Practitioner: LESLEY MELLOR M.S. CCC-SP

Information about “1205967577” NPI (LESLEY MELLOR M.S. CCC-SP) exists in 1205967577 in HTML format HTML  |  1205967577 in plain Text format TXT  |  1205967577 in PDF (Portable Document Format) PDF  |  1205967577 in an XML format XML  formats.

NPI Number : 1205967577 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205967577",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MELLOR",
    "FirstName": "LESLEY",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.S. CCC-SP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "14508 W CLARENDON AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GOODYEAR",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85338-8243",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "623-256-4880",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11047 N 79TH PL",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SCOTTSDALE",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85260-5598",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-619-6061",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/08/2007",
    "LastUpdateDate": "07/09/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "SLP4309",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.