MEDICARE: MELINDA MARIE WILLIAMS SLPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLPA7620	AZ

General Provider Information

NPI Number	:	1558633529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA MARIE WILLIAMS SLPA

Provider Business Mailing Address
First Line	:	5220 N DYSART RD
Second Line	:	B112
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-3045
Country	:	US
Telephone Number	:	623-935-6040
Fax Number	:

Provider Business Practice Location Address
First Line	:	5220 N DYSART RD
Second Line	:	B112
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-3045
Country	:	US
Telephone Number	:	623-935-6040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2012
Last Update Date	:	02/06/2012

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Directions to “ MELINDA MARIE WILLIAMS SLPA” Practice Location

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