=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477463669
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELINDA JO WILLIAMS M.A. CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2026
-----------------------------------------------------
Last Update Date | 09/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2085 W DRAHNER RD
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48371-4405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-572-9529
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2209 VALLEY VISTA DR
-----------------------------------------------------
City | DAVISON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48423-8365
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-240-2803
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 7101001454
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------