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General NPI Number Information
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NPI Number | 1629055108
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Entity Type | Individual
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Provider Name | MELISSA ANNE LEUPP OTR L
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Gender | Female
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1426 N QUINCY ST
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City | ARLINGTON
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State | VA
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Zip | 22207-3646
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Country | US
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Telephone | 703-228-2746
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Fax |
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Provider Business Mailing Address
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Address Line | 145 S GARFIELD ST
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City | ARLINGTON
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State | VA
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Zip | 22204-1841
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Country | US
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Telephone | 703-629-1848
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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 | 0119002624
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License Number State | VA
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