Individual
MELANIE NICOLE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
113 LIBERTY PKWY APT B10, SAINT ROBERT, MO 65584-4900
(662) 931-2777
Mailing address
113 LIBERTY PKWY APT B10, SAINT ROBERT, MO 65584-4900
(662) 931-2777
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2022031203
MO
224Z00000X
Occupational Therapy Assistant
3794
TN
224Z00000X
Occupational Therapy Assistant
Primary
OTA-3887
MS
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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