Provider Demographics
NPI:1164958138
Name:CEPEDA, MELISSA (OT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CEPEDA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16522 KEYSTONE BLVD
Mailing Address - Street 2:UNIT N
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3303
Mailing Address - Country:US
Mailing Address - Phone:303-840-7325
Mailing Address - Fax:303-840-7326
Practice Address - Street 1:1830 N FRANKLIN ST STE 450
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1128
Practice Address - Country:US
Practice Address - Phone:303-321-1333
Practice Address - Fax:303-321-0620
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005018225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist