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General NPI Number Information
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NPI Number | 1629663299
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Entity Type | Individual
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Provider Name | ABIGAIL LYNN MELVIN ODT
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Gender | Female
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 6180 HIGHWAY MM
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City | HOUSE SPRINGS
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State | MO
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Zip | 63051-2315
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Country | US
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Telephone | 636-671-3382
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Fax |
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Provider Business Mailing Address
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Address Line | 8961 S SWAN CIR
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City | SAINT LOUIS
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State | MO
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Zip | 63144-1717
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Country | US
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Telephone | 513-509-3743
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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 | 2021007751
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License Number State | MO
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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 |
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License Number State |
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