| Doctor Name: | MELANIE MIMS |
| NPI Number: | 1467618595 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 18734 |
| Business Practice Address: | 220 Ascalon Ct Johns Creek, GA - 300052526 |
| Business Phone Number: | 7137752272 |
| Business Fax Number: | 7704062629 |
| Mailing Address: | 220 Ascalon Ct, JOHNS CREEK |
| State: | GA |
| Postal Code: | 300052526 |
| Phone Number: | 7137752272 |
| Fax Number: | 7704062629 |
| NPI Enumeration Date: | 07/29/2008 |
| NPI Last Update Date: | 02/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 18734 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |