MEDICARE: MELISSA PAIGE CROWELL OTR/L

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
1	225XP0200X	Pediatric Occupational Therapist	OC018243	PA
2	225X00000X	Occupational Therapist	OC018243	PA

General Provider Information

NPI Number	:	1467197376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA PAIGE CROWELL OTR/L

Provider Business Mailing Address
First Line	:	27 VIOLET LN
Second Line	:
City	:	WEST GROVE
State	:	PA
Zip	:	19390-9531
Country	:	US
Telephone Number	:	484-643-8313
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 VIOLET LN
Second Line	:
City	:	WEST GROVE
State	:	PA
Zip	:	19390-9531
Country	:	US
Telephone Number	:	484-643-8313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2022
Last Update Date	:	05/04/2022

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