Doctor Name: | MELISSA DENYSE MCGILL |
NPI Number: | 1033422415 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLPA |
License Number: | |
Business Practice Address: | 2122 S 114th Ln Avondale, AZ - 853239184 |
Business Phone Number: | 9285668748 |
Business Fax Number: | |
Mailing Address: | Po Box 448, LAKE HAVASU CITY |
State: | AZ |
Postal Code: | 864050448 |
Phone Number: | 9285668748 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2010 |
NPI Last Update Date: | 07/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |