Provider Demographics
NPI:1316413941
Name:WHEELER, MELANIE E (OTR/L)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:E
Last Name:WHEELER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3616 BRITT ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2120
Mailing Address - Country:US
Mailing Address - Phone:607-239-7118
Mailing Address - Fax:
Practice Address - Street 1:5970 W CREEK RD
Practice Address - Street 2:
Practice Address - City:NEWARK VALLEY
Practice Address - State:NY
Practice Address - Zip Code:13811-1404
Practice Address - Country:US
Practice Address - Phone:607-239-7118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023048225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist