Provider Demographics
NPI:1124574439
Name:HOKENESS, MELISSA I
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HOKENESS
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:SOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PEDIATRIC THERAPY SERVICES
Mailing Address - Street 2:150 ST. ANDREWS CT. STE 310
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001
Mailing Address - Country:US
Mailing Address - Phone:507-388-2108
Mailing Address - Fax:
Practice Address - Street 1:150 SAINT ANDREWS CT
Practice Address - Street 2:SUITE 310
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-8659
Practice Address - Country:US
Practice Address - Phone:507-388-2108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104950225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics