Healthcare Provider Details

I. General information

NPI: 1356795231
Provider Name (Legal Business Name): MELISSA HULTON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 04/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 14TH ST NW
WASHINGTON DC
20011-6926
US

IV. Provider business mailing address

9503 VANCE PL
SILVER SPRING MD
20901-4720
US

V. Phone/Fax

Practice location:
  • Phone: 202-722-5555
  • Fax:
Mailing address:
  • Phone: 703-362-3526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT100000070
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: