Individual
MELINDA DOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
12015 TIVOLI AVE NE, HOOVER MS, ALBUQUERQUE, NM 87111-5309
(505) 298-6896
Mailing address
12015 TIVOLI AVE NE, HOOVER MS, ALBUQUERQUE, NM 87111-5309
(505) 298-6896
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1901
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L 5931
—
NM
Enumeration date
01/31/2007
Last updated
07/09/2007
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