Individual
MELISSA ANNE PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
795 WILLOW RD, MENLO PARK, CA 94025-2539
(650) 493-5000
Mailing address
14395 W PARK AVE, BOULDER CREEK, CA 95006-9304
(650) 493-5000
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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