Doctor Name: | MRS. MELANIE PEACOCK SHELL |
NPI Number: | 1669723763 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 000682SLP |
Business Practice Address: | 1014 Forsyth St Macon, GA - 312012051 |
Business Phone Number: | 4786332742 |
Business Fax Number: | |
Mailing Address: | 2490 Riverside Dr, Ste B MACON |
State: | GA |
Postal Code: | 31204 |
Phone Number: | 4786336633 |
Fax Number: | 4786334295 |
NPI Enumeration Date: | 09/28/2012 |
NPI Last Update Date: | 03/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 000682SLP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |