Provider Demographics
NPI:1346366176
Name:HOERDEMANN, MELISSA J (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:J
Last Name:HOERDEMANN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:J
Other - Last Name:GATLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS/OTR/L
Mailing Address - Street 1:1558 CLEARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3612
Mailing Address - Country:US
Mailing Address - Phone:484-366-9077
Mailing Address - Fax:
Practice Address - Street 1:1200 RIVER RD
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2442
Practice Address - Country:US
Practice Address - Phone:215-483-2461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010402225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist