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General NPI Number Information
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NPI Number | 1619470846
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Entity Type | Individual
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Provider Name | MELISSA MCCABE COTA/L
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Gender | Female
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 115 BEEMER CHURCH RD
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City | BRANCHVILLE
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State | NJ
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Zip | 07826-5704
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Country | US
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Telephone | 973-600-8715
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Fax |
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Provider Business Mailing Address
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Address Line | 115 BEEMER CHURCH RD
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City | BRANCHVILLE
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State | NJ
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Zip | 07826-5704
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Country | US
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Telephone | 973-600-8715
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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 | 46TA09111000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 008999-01
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License Number State | NY
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