Provider Demographics
NPI:1780149104
Name:HAGER, MELVA (SLPA)
Entity type:Individual
Prefix:MRS
First Name:MELVA
Middle Name:
Last Name:HAGER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3336
Mailing Address - Street 2:
Mailing Address - City:SOUTH PADRE ISLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78597-3336
Mailing Address - Country:US
Mailing Address - Phone:956-624-0017
Mailing Address - Fax:
Practice Address - Street 1:110 E. RETAMA
Practice Address - Street 2:UNIT 1
Practice Address - City:SOUTH PADRE ISLAND
Practice Address - State:TX
Practice Address - Zip Code:78597-3336
Practice Address - Country:US
Practice Address - Phone:956-624-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX351382355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant