Provider Demographics
NPI:1982251864
Name:THOMPSON, MELINA HELEN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELINA
Middle Name:HELEN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MELINA
Other - Middle Name:HELEN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:432 S CHARTER ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IL
Mailing Address - Zip Code:61856-1806
Mailing Address - Country:US
Mailing Address - Phone:818-913-9261
Mailing Address - Fax:
Practice Address - Street 1:400 E WABASH AVE
Practice Address - Street 2:
Practice Address - City:RANTOUL
Practice Address - State:IL
Practice Address - Zip Code:61866-3013
Practice Address - Country:US
Practice Address - Phone:217-893-5401
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 Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist