Provider Demographics
NPI:1164824793
Name:WEST, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:HOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4746 GARDENIA CIR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-9500
Mailing Address - Country:US
Mailing Address - Phone:252-883-1789
Mailing Address - Fax:
Practice Address - Street 1:500 FAIRWAY DR., BUTTERFLY EFFECTS LLC,
Practice Address - Street 2:STE. 102
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441
Practice Address - Country:US
Practice Address - Phone:888-880-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2024-03-01
Deactivation Date:2021-06-29
Deactivation Code:
Reactivation Date:2023-06-12
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist