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Individual

MRS. MELINDA ALEXANDRIA MIHALICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC SLP

Contact information

Practice address
1327 KALAKAKET STREET, FAIRBANKS, AK 99709
(907) 452-4517
(907) 452-4263
Mailing address
PO BOX 60543, FAIRBANKS, AK 99706
(907) 474-9705

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
230
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A021
TRICARE
05
SP4171
AK
Enumeration date
08/08/2007
Last updated
08/08/2007
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