Healthcare Provider Details

I. General information

NPI: 1811601149
Provider Name (Legal Business Name): MELANIE MACDONALD OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 OLD CANAL DR
LOWELL MA
01851-2730
US

IV. Provider business mailing address

18 WOBURN ST
LOWELL MA
01852-5528
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-1736
  • Fax:
Mailing address:
  • Phone: 978-239-3397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT61148459
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTL13752
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: