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Individual

MRS. MELISSA ELIZABETH AVERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSOT, OTR/L

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
001164
CT
225X00000X
Occupational Therapist
Primary
4088
CT

Other

Enumeration date
02/02/2011
Last updated
10/08/2013
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