Individual
MELISSA MELLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
12381 ROLLER COASTER RD, LISBON, OH 44432-9511
(330) 853-5467
Mailing address
12381 ROLLER COASTER RD, LISBON, OH 44432-9511
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
04298
OH
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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