Healthcare Provider Details
I. General information
NPI: 1518326313
Provider Name (Legal Business Name): MELISSA R JAMES OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/22/2016
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3326 AUSTIN BLUFFS PKWY STE 110
COLORADO SPRINGS CO
80918-5752
US
IV. Provider business mailing address
2210 LELARAY ST
COLORADO SPRINGS CO
80909-2220
US
V. Phone/Fax
- Phone: 719-912-2110
- Fax: 719-400-0413
- Phone: 719-475-0477
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | OT.0004579 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: