=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427505213
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. MELISSA STREIFF
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2016
-----------------------------------------------------
Last Update Date | 03/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 121 BULVERDE CROSSING RD STE 106
-----------------------------------------------------
City | BULVERDE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78163-6201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-245-7898
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1481 OLD BOERNE RD
-----------------------------------------------------
City | BULVERDE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78163-3215
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-833-8120
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 117882
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------