Provider Demographics
NPI:1902970791
Name:GRAY, MELINDA ANNE (AUD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:ANNE
Last Name:GRAY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:MELINDA
Other - Middle Name:MILFORD
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:6401 SHALLOWFORD RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-5406
Mailing Address - Country:US
Mailing Address - Phone:423-893-6500
Mailing Address - Fax:
Practice Address - Street 1:6401 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-5406
Practice Address - Country:US
Practice Address - Phone:423-893-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALA848231H00000X
TNA001305231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist