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General NPI Number Information
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NPI Number | 1841984838
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Entity Type | Individual
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Provider Name | MELINDA A. MATULA MS,OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 68 WATERFORD AVE
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City | MORGANVILLE
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State | NJ
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Zip | 07751-4246
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Country | US
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Telephone | 718-791-9787
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Fax |
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Provider Business Mailing Address
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Address Line | 627 LEES AVE
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City | COLLINGSWOOD
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State | NJ
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Zip | 08108-3127
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Country | US
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Telephone | 609-605-3068
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OC003069L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 46TR00178000
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License Number State | NJ
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