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General NPI Number Information
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NPI Number | 1992522643
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Entity Type | Individual
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Provider Name | MELISSA CHARLES MS
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Gender | Female
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Dates
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Enumeration Date | 09/24/2024
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 22800 HILDEBRANDT RD
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City | KLEIN
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State | TX
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Zip | 77389-4436
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Country | US
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Telephone | 832-249-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 183 GREATWOOD GLEN DR
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City | MONTGOMERY
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State | TX
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Zip | 77316-1590
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Country | US
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Telephone | 703-334-1101
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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 | 121166
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License Number State | TX
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