Individual
MELINDA TARBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
36 BROADWAY ST, COLCHESTER, CT 06415-1002
(860) 537-4606
Mailing address
113 WEST ST, COLUMBIA, CT 06237-1341
(860) 560-3477
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
003535
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003535
DPH
CT
Enumeration date
02/28/2019
Last updated
02/28/2019
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