Provider Demographics
NPI:1598065914
Name:COBABE, MELANIE ANN (MS)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ANN
Last Name:COBABE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:MELANIE
Other - Middle Name:ANN
Other - Last Name:TOMLINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:689 WYMOUNT TER
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-2042
Mailing Address - Country:US
Mailing Address - Phone:801-357-9919
Mailing Address - Fax:
Practice Address - Street 1:689 WYMOUNT TER
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-2042
Practice Address - Country:US
Practice Address - Phone:801-357-9919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7815328-4104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist