Provider Demographics
NPI:1215146121
Name:MELENDEZ, ANNE REICH (OTA)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:REICH
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 JUNE ST
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01571-5817
Mailing Address - Country:US
Mailing Address - Phone:508-949-1933
Mailing Address - Fax:
Practice Address - Street 1:97 PRESTON RD
Practice Address - Street 2:
Practice Address - City:GRISWOLD
Practice Address - State:CT
Practice Address - Zip Code:06351-2516
Practice Address - Country:US
Practice Address - Phone:860-376-4438
Practice Address - Fax:860-376-8343
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000978224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant