Individual
MRS. MELISSA J KNICKERBOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
45 MERIDEN AVE, SOUTHINGTON, CT 06489-3214
(860) 378-1234
Mailing address
422 WESTLAND AVE, CHESHIRE, CT 06410-3142
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
003222
CT
Other
Enumeration date
11/11/2007
Last updated
11/11/2007
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