Individual
MELANIE LEWELLYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
895 N 6TH E, MOUNTAIN HOME, ID 83647-2207
(208) 587-8401
Mailing address
895 N 6TH E, MOUNTAIN HOME, ID 83647-2207
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-713
ID
Other
Enumeration date
01/20/2014
Last updated
01/20/2014
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