Provider Demographics
NPI:1730307844
Name:BUTLER, MELISSA GAIL (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:GAIL
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8036 E WINDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6438
Mailing Address - Country:US
Mailing Address - Phone:480-326-2619
Mailing Address - Fax:602-297-6727
Practice Address - Street 1:10810 N TATUM BLVD # 102-185
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6055
Practice Address - Country:US
Practice Address - Phone:480-326-2619
Practice Address - Fax:602-297-6727
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0373235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist