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General NPI Number Information
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NPI Number | 1184090029
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Entity Type | Individual
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Provider Name | MELISSA BUSEFINK O.T.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2015
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 2574 CADWALLADER SONK RD
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City | CORTLAND
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State | OH
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Zip | 44410-9439
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Country | US
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Telephone | 330-282-2614
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Fax |
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Provider Business Mailing Address
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Address Line | 2574 CADWALLADER SONK RD
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City | CORTLAND
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State | OH
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Zip | 44410-9439
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Country | US
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Telephone | 330-282-2614
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OH1333448
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License Number State | OH
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