Individual
MELISSA GAYLE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA-CCC/SLP
Contact information
Practice address
1451 DIEDERICH BLVD, RUSSELL, KY 41169-1718
(606) 388-4511
Mailing address
1451 DIEDERICH BLVD, RUSSELL, KY 41169-1718
(606) 388-4511
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
141190
KY
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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