Doctor Name: | SHANNON CHRISTIE MELLONE |
NPI Number: | 1750760377 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | SZ 7090 |
Business Practice Address: | 409 E Oakland Ave Unit B Oakland, FL - 347873070 |
Business Phone Number: | 4076545455 |
Business Fax Number: | |
Mailing Address: | 179 City Point Rd, COCOA |
State: | FL |
Postal Code: | 329268745 |
Phone Number: | 3215446608 |
Fax Number: | |
NPI Enumeration Date: | 05/28/2015 |
NPI Last Update Date: | 05/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SZ 7090 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |