Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC013220 | PA |
N | 225XH1200X | Occupational Therapist - Hand | 0119003682 | VA |
NPI | 1003194606 |
---|---|
Provider Name | Mrs. Melissa Fox |
First Address | Sayre, PA 18840-1625 |
Second Address | Sayre, PA 18840-1625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2011 |
Last Update Date | 09/04/2021 |