Healthcare Provider Details

I. General information

NPI: 1700124567
Provider Name (Legal Business Name): MELANIE SILVERS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 POINTE NORTH DR STE 109
CARTERSVILLE GA
30120-7955
US

IV. Provider business mailing address

10 MAPLE GROVE DR
ADAIRSVILLE GA
30103-3061
US

V. Phone/Fax

Practice location:
  • Phone: 770-608-8525
  • Fax: 470-588-8934
Mailing address:
  • Phone: 770-608-8525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT006369
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: