Provider Demographics
NPI:1164031787
Name:SANCHEZ, MELISSA CAYETANO (OCCUPATIONAL THERAPY)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:CAYETANO
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6990 WYNDHAM WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2761
Mailing Address - Country:US
Mailing Address - Phone:651-245-5003
Mailing Address - Fax:
Practice Address - Street 1:6990 WYNDHAM WAY
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2761
Practice Address - Country:US
Practice Address - Phone:651-245-5003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105707225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist