Provider Demographics
NPI:1033369350
Name:MELARAGNO, STACY
Entity Type:Individual
Prefix:MISS
First Name:STACY
Middle Name:
Last Name:MELARAGNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 BRAINARD RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3096
Mailing Address - Country:US
Mailing Address - Phone:440-460-1000
Mailing Address - Fax:
Practice Address - Street 1:1575 BRAINARD RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-3096
Practice Address - Country:US
Practice Address - Phone:440-460-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6208225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6208OtherOCCUPATIONAL THERAPIST