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General NPI Number Information
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NPI Number | 1841825536
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Entity Type | Organization
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Legal Business Name | SPEECH BY MELISSA LLC
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Dates
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Enumeration Date | 03/03/2020
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 4301 N SARA RD STE 120
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City | YUKON
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State | OK
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Zip | 73099-3682
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Country | US
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Telephone | 405-982-2086
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Fax | 405-900-4062
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Provider Business Mailing Address
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Address Line | 4301 N SARA RD STE 120
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City | YUKON
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State | OK
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Zip | 73099-3682
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Country | US
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Telephone | 405-328-8781
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA KAY LONGHURST
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Credential | MS CCC-SLP
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Telephone | 405-328-8781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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