Individual
MELISSA MATTINGLY-MARDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
991 MARTIN RD, CAMPBELLSVILLE, KY 42718-9726
(270) 692-8826
(270) 789-6531
Mailing address
991 MARTIN RD, CAMPBELLSVILLE, KY 42718-9726
(270) 692-8826
(270) 789-6531
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
R2253
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01924
FIRST STEPS
KY
Enumeration date
08/06/2007
Last updated
08/06/2007
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