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General NPI Number Information
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NPI Number | 1619273141
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Entity Type | Individual
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Provider Name | MELISSA ELAINE CORDELL MOTR
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Gender | Female
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Dates
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Enumeration Date | 02/01/2011
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 2416 SE 22ND PL
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City | OCALA
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State | FL
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Zip | 34471-8221
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Country | US
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Telephone | 920-946-3594
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Fax |
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Provider Business Mailing Address
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Address Line | 2416 SE 22ND PL
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City | OCALA
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State | FL
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Zip | 34471-8221
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Country | US
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Telephone | 920-946-3594
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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 | 4865-026
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT14808
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License Number State | FL
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