Provider Demographics
NPI:1114473121
Name:HIGGINS, MELANIE (MHS, OTR/L)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5989 MEIJER DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-4932
Mailing Address - Country:US
Mailing Address - Phone:513-575-5431
Mailing Address - Fax:
Practice Address - Street 1:5989 MEIJER DR
Practice Address - Street 2:SUITE 4
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-4932
Practice Address - Country:US
Practice Address - Phone:513-575-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-4832225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist