MEDICARE: MELISSA HAAS OTR, APSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	131988-121	WI
2	225XP0200X	Pediatric Occupational Therapist
3	225XP0200X	Pediatric Occupational Therapist	3516-26	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619165578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA HAAS OTR, APSW

Provider Business Mailing Address
First Line	:	725 W PARK AVE
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-3276
Country	:	US
Telephone Number	:	715-210-8336
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 W PARK AVE
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-3399
Country	:	US
Telephone Number	:	715-723-0341
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	01/08/2025

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