Healthcare Provider Details

I. General information

NPI: 1912844564
Provider Name (Legal Business Name): ALEXIS MELENDREZ OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5761 E BROWN RD STE 19
MESA AZ
85205-4449
US

IV. Provider business mailing address

1844 E BASELINE RD STE C5
TEMPE AZ
85283-1506
US

V. Phone/Fax

Practice location:
  • Phone: 480-719-8080
  • Fax: 480-981-8595
Mailing address:
  • Phone: 480-833-1005
  • Fax: 480-833-1312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTH-010259
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: