Provider Demographics
NPI:1588779177
Name:PAMPUSH, MELINDA LEE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:LEE
Last Name:PAMPUSH
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:PAMPUSH
Other - Middle Name:LEE
Other - Last Name:MINDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1603 VRAIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-1132
Mailing Address - Country:US
Mailing Address - Phone:720-339-7143
Mailing Address - Fax:
Practice Address - Street 1:1603 VRAIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1132
Practice Address - Country:US
Practice Address - Phone:720-339-7143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO77427378Medicaid