Individual
JENNY ELIZABETH MELLOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
16 GRAVES DR, DAYTON, NV 89403-6300
(925) 437-8098
Mailing address
16 GRAVES DR, DAYTON, NV 89403-6300
(925) 437-8098
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3229087230
—
NV
Enumeration date
09/13/2019
Last updated
09/13/2019
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