Provider Demographics
NPI:1093562316
Name:MELANSON, LAUREN-ASHLEY ROSE (MS)
Entity type:Individual
Prefix:
First Name:LAUREN-ASHLEY
Middle Name:ROSE
Last Name:MELANSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 STILLWATER AVE
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-3410
Mailing Address - Country:US
Mailing Address - Phone:207-631-1791
Mailing Address - Fax:
Practice Address - Street 1:840 KENNEDY MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-4887
Practice Address - Country:US
Practice Address - Phone:207-716-1863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist