Individual
HOLLY MELLENTHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(618) 635-2200
(618) 635-2200
Mailing address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(618) 635-2200
(618) 635-2200
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
57002654
IL
Other
Enumeration date
07/10/2026
Last updated
07/10/2026
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