Provider Demographics
NPI:1528106390
Name:SCHOWALTER, MELISSA (MS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SCHOWALTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 S PAYNE STEWART DR
Mailing Address - Street 2:B
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2792
Mailing Address - Country:US
Mailing Address - Phone:417-335-3636
Mailing Address - Fax:417-335-3626
Practice Address - Street 1:186 S PAYNE STEWART DR
Practice Address - Street 2:B
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2792
Practice Address - Country:US
Practice Address - Phone:417-335-3636
Practice Address - Fax:417-335-3626
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO114017231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO338936701Medicaid
MO000580001Medicare PIN