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General NPI Number Information
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NPI Number | 1003144726
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Entity Type | Individual
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Provider Name | MELISSA ANN O'BRIEN COTA/L
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Gender | Female
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 3001 E EVESHAM RD
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City | VOORHEES
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State | NJ
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Zip | 08043-9547
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Country | US
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Telephone | 856-751-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 508 STEVENS DR
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City | MOUNT HOLLY
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State | NJ
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Zip | 08060-1218
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Country | US
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Telephone | 609-261-3199
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 46TA09053700
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License Number State | NJ
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