Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand |
NPI | 1104594357 |
---|---|
Provider Name | Melissa Kay Clift |
First Address | Fort Leonard Wood, MO 65473-9098 |
Second Address | Fort Leonard Wood, MO 65473-9098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2021 |
Last Update Date | 02/09/2021 |