Provider Demographics
NPI:1205001476
Name:SARRO, MELANIE KING (LOTR)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:KING
Last Name:SARRO
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 RAINTREE CV
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-7710
Mailing Address - Country:US
Mailing Address - Phone:337-562-0558
Mailing Address - Fax:
Practice Address - Street 1:22 RAINTREE CV
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-7710
Practice Address - Country:US
Practice Address - Phone:337-562-0558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ11538225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics