Healthcare Provider Details

I. General information

NPI: 1942693148
Provider Name (Legal Business Name): MELANIE FRANCES PEREZ OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 CHESTNUT STATION CT PARAGON REHABILITATION
LOUISVILLE KY
40299-6395
US

IV. Provider business mailing address

5812 PRAIRIE ROSE DR
SCHERERVILLE IN
46375-5341
US

V. Phone/Fax

Practice location:
  • Phone: 800-335-1060
  • Fax:
Mailing address:
  • Phone: 219-670-5086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31004062A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: