Provider Demographics
NPI:1144680356
Name:CHAMBERLIN, MELODY
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W HYDE PARK PL
Mailing Address - Street 2:APARTMENT 204
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2343
Mailing Address - Country:US
Mailing Address - Phone:352-238-5337
Mailing Address - Fax:
Practice Address - Street 1:204 W HYDE PARK PL
Practice Address - Street 2:APARTMENT 204
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2343
Practice Address - Country:US
Practice Address - Phone:352-238-5337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist