Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 32002265A | IN |
NPI | 1013268366 |
---|---|
Provider Name | Melissa Lynn Orellana |
First Address | Seymour, IN 47274-4604 |
Second Address | Seymour, IN 47274-4604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2012 |
Last Update Date | 26/09/2012 |