Provider Demographics
NPI:1396991303
Name:PIPES, MELODYE JAN (CCC/SLP)
Entity type:Individual
Prefix:
First Name:MELODYE
Middle Name:JAN
Last Name:PIPES
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 PEREGRINE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-8122
Mailing Address - Country:US
Mailing Address - Phone:405-579-4469
Mailing Address - Fax:
Practice Address - Street 1:3625 PEREGRINE DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-8122
Practice Address - Country:US
Practice Address - Phone:405-579-4469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-09
Last Update Date:2008-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2752235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist