Provider Demographics
NPI:1316458334
Name:AYOTTE, MELISSA ANN (MA, ATR-BC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:AYOTTE
Suffix:
Gender:F
Credentials:MA, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NORTHWOODS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4716
Mailing Address - Country:US
Mailing Address - Phone:614-769-7221
Mailing Address - Fax:
Practice Address - Street 1:30 NORTHWOODS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4716
Practice Address - Country:US
Practice Address - Phone:614-769-7221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical
Provider Identifiers
StateIdentifier IDID TypeIssuer
15-368OtherART THERAPY CREDENTIALS BOARD