Individual
MRS. SHANNON LEIGH MELLOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
154 N ARTIZAN ST, WILLIAMSPORT, MD 21795-1104
(301) 223-7971
(301) 223-7941
Mailing address
5823 CHARLESTOWN RD, MERCERSBURG, PA 17236-9442
(717) 325-1018
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A01493
MD
224Z00000X
Occupational Therapy Assistant
OP005813
PA
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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