MEDICARE: MS. MELANIE ANNE SMITH CCC-MS

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	873340	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14312949	OTHER	WI	ASHA

General Provider Information

NPI Number	:	1578409843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELANIE ANNE SMITH CCC-MS

Provider Business Mailing Address
First Line	:	1800 EAST AVE
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481-3709
Country	:	US
Telephone Number	:	715-345-5418
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 EAST AVE
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481-3709
Country	:	US
Telephone Number	:	715-544-0045
Fax Number	:

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

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	04/28/2026

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