# MRS. MELISSA S PETTAVINO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1548391121
- **Gender:** F
- **Credential:** PT, MPT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 04135 | LA | — |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | LA | — |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 05/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1315795 | — | LA |