Individual
MELINDA MACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
314 FLORIDA AVE, PORTSMOUTH, VA 23707
(813) 817-1903
Mailing address
314 FLORIDA AVE, PORTSMOUTH, VA 23707
(813) 817-1903
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 62
HI
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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