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Individual

MISS MELODY GRACE CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2001 SCENIC DR, GEORGETOWN, TX 78626
(228) 342-2774
Mailing address
2001 SCENIC DR, GEORGETOWN, TX 78626-7725
(228) 342-2774

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212794
TX

Other

Enumeration date
06/11/2015
Last updated
08/24/2018
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