Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1376146381 |
---|---|
Provider Name | Melissa Fleming |
First Address | Castle Pines, CO 80108-8255 |
Second Address | Castle Pines, CO 80108-8255 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2020 |
Last Update Date | 20/11/2020 |