Provider Demographics
NPI:1144806431
Name:OVERBECK, MELISSA CAROL
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:CAROL
Last Name:OVERBECK
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 1:9432 BREHM RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45252-2610
Mailing Address - Country:US
Mailing Address - Phone:513-313-8241
Mailing Address - Fax:
Practice Address - Street 1:9432 BREHM RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45252-2610
Practice Address - Country:US
Practice Address - Phone:513-313-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care