Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OC010069 | PA |
Y | 225X00000X | Occupational Therapist | U1-0001630 | DE |
NPI | 1003416801 |
---|---|
Provider Name | Melissa Theresa Martinelli |
First Address | Wilmington, DE 19803-3301 |
Second Address | Wilmington, DE 19803-3301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2020 |
Last Update Date | 29/10/2020 |