| Doctor Name: | MELANIE JEAN EDMONDSON |
| NPI Number: | 1760709273 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ST |
| License Number: | 22004984A |
| Business Practice Address: | 51738 Sagecrest Dr Granger, IN - 465306887 |
| Business Phone Number: | 5743395959 |
| Business Fax Number: | |
| Mailing Address: | 3371 Cleveland Road Ext, Suite 210 SOUTH BEND |
| State: | IN |
| Postal Code: | 466289780 |
| Phone Number: | 5742712558 |
| Fax Number: | 5742731137 |
| NPI Enumeration Date: | 04/23/2010 |
| NPI Last Update Date: | 04/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 22004984A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| 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 |