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Individual

MELLISA FANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD

Contact information

Practice address
717 MARINA PARK DR SE, HUNTSVILLE, AL 35803-3034
(256) 684-3368
Mailing address
717 MARINA PARK DR SE, HUNTSVILLE, AL 35803-3034
(256) 684-3368

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2394
AL

Other

Enumeration date
01/21/2021
Last updated
01/21/2021
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