Individual
MELISSA MATTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5901 NW 79TH AVE, TAMARAC, FL 33321-4639
(754) 250-9099
Mailing address
5901 NW 79TH AVE, TAMARAC, FL 33321-4639
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17083
FL
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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