Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1264 | CO |
N | 225XF0002X | Feeding, Eating & Swallowing | 1264 | CO |
N | 225XP0200X | Occupational Therapist - Pediatrics | 1264 | CO |
NPI | 1982116471 |
---|---|
Provider Name | Melanie Batista |
First Address | Bluffton, SC 29910-9347 |
Second Address | Bluffton, SC 29910-9347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2017 |
Last Update Date | 02/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1041514 | NBCOT (01) | |
1264 | DORA LICENSE (01) | CO |