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General NPI Number Information
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NPI Number | 1275731077
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Entity Type | Individual
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Provider Name | MELANIE KIM RAFFENSPERGER OTRL
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 2509 7TH AVE S SUITE C4
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City | GREAT FALLS
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State | MT
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Zip | 59405-3030
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Country | US
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Telephone | 406-216-5995
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Fax | 406-216-5935
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Provider Business Mailing Address
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Address Line | PO BOX 3593
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City | GREAT FALLS
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State | MT
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Zip | 59403-3593
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Country | US
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Telephone | 406-216-5995
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Fax | 406-216-5935
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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 | 1019
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License Number State | MT
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