Healthcare Provider Details

I. General information

NPI: 1265502488
Provider Name (Legal Business Name): MELISSA L BROWN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISAS L SABO OT

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 CURRY RD
WAYNESBURG PA
15370-3415
US

IV. Provider business mailing address

257 FRANCES LN
MC DONALD PA
15057-2744
US

V. Phone/Fax

Practice location:
  • Phone: 724-852-6229
  • Fax: 724-852-6229
Mailing address:
  • Phone: 412-983-5983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC008748
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: