Individual
MELLISA NICHOLE OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
676 LAUREL BRANCH, HAYSI, VA 24256
(276) 865-4229
Mailing address
676 LAUREL BRANCH RD, HAYSI, VA 24256
(276) 865-4229
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000626
VA
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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