Individual
MRS. MELISSA ANN DEFAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
285 STRATFORD LN, XENIA, OH 45385-8961
(937) 372-2291
Mailing address
285 STRATFORD LN, XENIA, OH 45385-8961
(937) 372-2291
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2101
OH
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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