Individual
MRS. MELODY MILLSAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
100 E FERGUSON ST STE 1204, TYLER, TX 75702-5700
(903) 509-2040
Mailing address
6351 FM 1616, ATHENS, TX 75752-6841
(903) 477-2695
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210673
TX
Other
Enumeration date
07/31/2016
Last updated
07/31/2016
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