Individual
LISA MELODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6901 N CHARLES ST, TOWSON, MD 21204-3780
(410) 627-5390
Mailing address
126A SNOW CHIEF DR, HAVRE DE GRACE, MD 21078-2577
(410) 627-5390
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
02915
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02915
CCC-SLP
MD
Enumeration date
10/25/2018
Last updated
05/20/2019
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