Individual
MELANIE ELAINE DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
12441 SE STARK ST, PORTLAND, OR 97233-1053
(503) 255-7040
Mailing address
3726 SE 132ND AVE, PORTLAND, OR 97236-3318
(503) 760-7073
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11322
OR
Other
Enumeration date
08/05/2012
Last updated
08/05/2012
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