Provider Demographics
NPI:1215275987
Name:WENZ, MELODY LEE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:LEE
Last Name:WENZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 VANDER HORCK AVE.
Mailing Address - Street 2:WHEATCREST HILLS
Mailing Address - City:BRITTON
Mailing Address - State:SD
Mailing Address - Zip Code:57430
Mailing Address - Country:US
Mailing Address - Phone:605-448-2251
Mailing Address - Fax:605-448-5583
Practice Address - Street 1:1311 VANDER HORCK AVE.
Practice Address - Street 2:WHEATCREST HILLS
Practice Address - City:BRITTON
Practice Address - State:SD
Practice Address - Zip Code:57430
Practice Address - Country:US
Practice Address - Phone:605-448-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD12146908235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist