Individual
MISS MELISSA MARIE MATAMOROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
12710 RESEARCH BLVD, SUITE 395, AUSTIN, TX 78759-4379
(512) 331-4115
(512) 331-8176
Mailing address
12710 RESEARCH BLVD, SUITE 395, AUSTIN, TX 78759-4379
(512) 331-4115
(512) 331-8176
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
110860
TX
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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