Healthcare Provider Details

I. General information

NPI: 1447666201
Provider Name (Legal Business Name): MELINDA IPPOLITO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 MEADOW CREEK DR STE 211
WESTMINSTER MD
21158-9455
US

IV. Provider business mailing address

1109 SINGER DR
WESTMINSTER MD
21157-5841
US

V. Phone/Fax

Practice location:
  • Phone: 410-984-5016
  • Fax:
Mailing address:
  • Phone: 410-984-5016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number06122
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: