Provider Demographics
NPI:1285982926
Name:HAMMONDS, MELINDA DAWN (COTA)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:DAWN
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 SHENANDOAH TRL
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-2939
Mailing Address - Country:US
Mailing Address - Phone:940-391-9135
Mailing Address - Fax:
Practice Address - Street 1:2300 POOL RD
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-4254
Practice Address - Country:US
Practice Address - Phone:817-410-3757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208065224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant