Provider Demographics
NPI:1093871840
Name:PENSAK, MELANIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:PENSAK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 REAGANS RD APT 632
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-1582
Mailing Address - Country:US
Mailing Address - Phone:412-632-4282
Mailing Address - Fax:
Practice Address - Street 1:24600 SILVER CLOUD CT STE 104
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-6555
Practice Address - Country:US
Practice Address - Phone:831-645-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23352235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist