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NPI Code Detail

MEDICARE: MELINDA MICHELLE STALEY SLP

MEDICARE: MELINDA MICHELLE STALEY SLP
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
1235Z00000XSpeech-Language Pathologist103404TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1103404OTHERTXLICENSE

General Provider Information

NPI Number : 1720274293
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELINDA MICHELLE STALEY SLP
Provider Business Mailing Address
First Line : 8326 COLEUS LN
Second Line :
City : BAYTOWN
State : TX
Zip : 77521-8257
Country : US
Telephone Number : 832-729-8716
Fax Number :
Provider Business Practice Location Address
First Line : 9600 EAGLE DR
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-5614
Country : US
Telephone Number : 281-576-2221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2007
Last Update Date : 03/06/2024

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