Individual
SHANNON MELLEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
825 N CENTER AVE, GAYLORD, MI 49735-1592
(989) 731-3894
(989) 731-7787
Mailing address
825 N CENTER AVE, GAYLORD, MI 49735-1592
(989) 731-3894
(989) 731-7787
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7152000771
MI
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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