| Doctor Name: | MELANIE MOORE |
| NPI Number: | 1730410721 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | S3338 |
| Business Practice Address: | 90 A Clark Boulevard Tupelo, MS - 38801 |
| Business Phone Number: | 6628400535 |
| Business Fax Number: | 6628427915 |
| Mailing Address: | Po Box 3592, TUPELO |
| State: | MS |
| Postal Code: | 388033592 |
| Phone Number: | 6628400535 |
| Fax Number: | 6628427915 |
| NPI Enumeration Date: | 01/15/2010 |
| NPI Last Update Date: | 01/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | S3338 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| 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 |