Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT 14307 | FL |
NPI | 1003018607 |
---|---|
Provider Name | Melissa Jean Meikle |
First Address | Melbourne, FL 32940-6996 |
Second Address | Rockledge, FL 32955-2738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 28/10/2019 |