MEDICARE: MELISSA ANZIANO 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	225X00000X	Occupational Therapist	OT004814	GA

General Provider Information

NPI Number	:	1962652297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANZIANO OTR/L

Provider Business Mailing Address
First Line	:	1835 SAVOY DR
Second Line	:	101B
City	:	ATLANTA
State	:	GA
Zip	:	30341-1072
Country	:	US
Telephone Number	:	678-298-9484
Fax Number	:

Provider Business Practice Location Address
First Line	:	1835 SAVOY DR
Second Line	:	101B
City	:	ATLANTA
State	:	GA
Zip	:	30341-1072
Country	:	US
Telephone Number	:	678-298-9484
Fax Number	:

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

Provider Enumeration Date	:	09/23/2008
Last Update Date	:	10/10/2016

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