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NPI Code Detail

MEDICARE: MELISSA ROHOLT

MEDICARE: MELISSA ROHOLT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1226000000XRecreational Therapist Assistant11565772-4003UT
2226000000XRecreational Therapist Assistant

General Provider Information

NPI Number : 1124904800
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA ROHOLT
Provider Business Mailing Address
First Line : 775 N 200 E
Second Line :
City : BRIGHAM CITY
State : UT
Zip : 84302-1303
Country : US
Telephone Number : 435-723-7777
Fax Number :
Provider Business Practice Location Address
First Line : 775 N 200 E
Second Line :
City : BRIGHAM CITY
State : UT
Zip : 84302-1303
Country : US
Telephone Number : 435-723-7777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2025
Last Update Date : 08/15/2025

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Directions to “ MELISSA ROHOLT ” Practice Location

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