Provider Demographics
NPI:1235520743
Name:SANON, MELISSA (COTA/L)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SANON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 WESTMEAD DR APT 3407
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-4608
Mailing Address - Country:US
Mailing Address - Phone:386-453-0729
Mailing Address - Fax:
Practice Address - Street 1:1910 WESTMEAD DR APT 3407
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4608
Practice Address - Country:US
Practice Address - Phone:386-453-0729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212037224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant