Provider Demographics
NPI:1992303234
Name:EVANS, MELISSA ANN (LOTR)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:EVANS
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 LOVELAND ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4336
Mailing Address - Country:US
Mailing Address - Phone:504-919-0220
Mailing Address - Fax:
Practice Address - Street 1:3501 SEVERN AVE STE 8
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3456
Practice Address - Country:US
Practice Address - Phone:504-249-8231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation