Healthcare Provider Details

I. General information

NPI: 1285085183
Provider Name (Legal Business Name): MELANIE CARIN BOND MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7905 N MEADOWLARK WAY STE B
COEUR D ALENE ID
83815-5041
US

IV. Provider business mailing address

8037 N WESTVIEW DR
COEUR D ALENE ID
83815-9576
US

V. Phone/Fax

Practice location:
  • Phone: 208-772-3116
  • Fax: 208-772-7677
Mailing address:
  • Phone: 559-352-0607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3771074
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-1633
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: