Provider Demographics
NPI:1225054752
Name:MAXWELL, MELANIE MILLS (MSOT,OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:MILLS
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:MSOT,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 TOOMER KILN CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-9063
Mailing Address - Country:US
Mailing Address - Phone:843-881-2302
Mailing Address - Fax:
Practice Address - Street 1:3415 TOOMER KILN CIR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-9063
Practice Address - Country:US
Practice Address - Phone:843-224-8979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1983225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics