Individual
MELISSA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
90 CLARK BLVD STE A, TUPELO, MS 38804-2801
(662) 840-0535
(662) 842-7915
Mailing address
PO BOX 3592, TUPELO, MS 38803-3592
(662) 840-0535
(662) 842-7915
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 1197
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00230121
—
MS
Enumeration date
03/22/2011
Last updated
01/14/2022
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