Basic Information
| Provider Information | |||||||||
| NPI: | 1700831203 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IWO | ||||||||
| FirstName: | MELISSA | ||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1529 | ||||||||
| Address2: | |||||||||
| City: | REEDLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936541529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592256100 | ||||||||
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| Practice Location | |||||||||
| Address1: | VACCHCS 570 (AUDIOLOGY) | ||||||||
| Address2: | 2615 E. CLINTON AVE. | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592256100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AU1477 | CA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.