Individual
MELISSA TIVNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1037 MAIN ST, LEICESTER, MA 01524-1313
(508) 892-1335
(508) 892-1780
Mailing address
703 GRANITE ST STE 3, BRAINTREE, MA 02184-5350
(781) 961-3370
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
225X00000X
Occupational Therapist
Primary
OTL15187
MA
Other
Enumeration date
05/04/2023
Last updated
02/20/2024
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