Individual
MRS. STACIE RENEE' MELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP-A
Contact information
Practice address
8245 N 27TH AVE APT 1035, PHOENIX, AZ 85051-6362
(602) 697-6014
Mailing address
8245 N 27TH AVE APT 1035, PHOENIX, AZ 85051-6362
(602) 697-6014
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA8403
AZ
Other
Enumeration date
07/12/2013
Last updated
07/12/2013
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