Provider Demographics
NPI:1932756822
Name:MELENDEZ, LEAH LYNN (MA)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:LYNN
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 HILLTOP CIR
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1507
Mailing Address - Country:US
Mailing Address - Phone:440-328-5291
Mailing Address - Fax:
Practice Address - Street 1:821 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-2035
Practice Address - Country:US
Practice Address - Phone:419-547-9868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-24
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20191188-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist