Basic Information
| Provider Information | |||||||||
| NPI: | 1902977234 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'BRIEN | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | SUSAN | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | DUMC 3887 | ||||||||
| Address2: | 1701 CLINIC 1-I, TRENT DRIVE | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277100001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196843859 | ||||||||
| FaxNumber: | 9196682741 | ||||||||
| Practice Location | |||||||||
| Address1: | DUMC 3887 | ||||||||
| Address2: | 1701 CLINIC 1-I, TRENT DRIVE | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277100001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196843859 | ||||||||
| FaxNumber: | 9196682741 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2006 | ||||||||
| LastUpdateDate: | 04/13/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 8426 | NC | Y | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | 01096 | MD | N | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.