Individual
MRS. STACIE RENEE' MELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
15802 N PARKVIEW PL, SURPRISE, AZ 85374-7466
(623) 876-7000
Mailing address
11711 W PATRICK CT, SUN CITY, AZ 85373-5437
(602) 697-6014
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA8403
AZ
235Z00000X
Speech-Language Pathologist
Primary
SLP8403
AZ
Other
Enumeration date
07/12/2013
Last updated
07/08/2026
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