Provider Demographics
NPI:1285087049
Name:BROWN, MELANIE ANN MINARD (MOT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN MINARD
Last Name:BROWN
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:A
Other - Last Name:FLANNERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT
Mailing Address - Street 1:1910 S ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3534
Mailing Address - Country:US
Mailing Address - Phone:248-218-5150
Mailing Address - Fax:248-218-5155
Practice Address - Street 1:1910 S ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3534
Practice Address - Country:US
Practice Address - Phone:248-218-5150
Practice Address - Fax:248-218-5155
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009532225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist