Provider Demographics
NPI:1427490630
Name:MELE, SARA GREEN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:GREEN
Last Name:MELE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MARGARET
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1866 HOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-2930
Mailing Address - Country:US
Mailing Address - Phone:312-286-0891
Mailing Address - Fax:
Practice Address - Street 1:1866 HOOD AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-2930
Practice Address - Country:US
Practice Address - Phone:312-286-0891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5845235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist