Provider Demographics
NPI:1073595195
Name:WELSH, MELINDA A (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:A
Last Name:WELSH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:PROSPECT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19076-1724
Mailing Address - Country:US
Mailing Address - Phone:610-532-0622
Mailing Address - Fax:
Practice Address - Street 1:1600 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4722
Practice Address - Country:US
Practice Address - Phone:302-656-2521
Practice Address - Fax:302-656-2620
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1 0000878225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000041626Medicaid
DE0000041626Medicaid