Individual
MS. MELANIE M CLEMENTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
135224
KY
225XP0200X
Pediatric Occupational Therapist
KY-R1473
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001033112
ANTHEM
KY
01
—
50116410
PASSPORT HEALTH
KY
05
—
7100400430
—
KY
Enumeration date
05/26/2007
Last updated
01/12/2017
Update your record
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