Healthcare Provider Details

I. General information

NPI: 1265361117
Provider Name (Legal Business Name): MELISSA LYNN FIRCHAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38257 MOUND RD
STERLING HEIGHTS MI
48310-3466
US

IV. Provider business mailing address

40595 SANTONI DR
CLINTON TOWNSHIP MI
48038-4159
US

V. Phone/Fax

Practice location:
  • Phone: 586-722-7524
  • Fax:
Mailing address:
  • Phone: 586-995-1151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5202006808
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: