Individual
MRS. MELISSA S PETTAVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
04135
LA
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1315795
—
LA
Enumeration date
03/08/2007
Last updated
05/19/2022
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