Provider Demographics
NPI:1154631067
Name:CHALLEEN, MELISSA (MS,OTR/L)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CHALLEEN
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 INVERNESS WAY S STE 125
Mailing Address - Street 2:UNIT 300
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5820
Mailing Address - Country:US
Mailing Address - Phone:720-273-7370
Mailing Address - Fax:720-273-7370
Practice Address - Street 1:304 INVERNESS WAY S
Practice Address - Street 2:STE. 125
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-5828
Practice Address - Country:US
Practice Address - Phone:720-273-7370
Practice Address - Fax:720-273-7370
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1978225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist