Provider Demographics
NPI:1346548773
Name:THOMAS, MELISSA R (OT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:R
Other - Last Name:OBRECHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:4851 E PICKARD ST STE 2600
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2042
Mailing Address - Country:US
Mailing Address - Phone:989-775-1662
Mailing Address - Fax:989-775-1604
Practice Address - Street 1:4851 E PICKARD ST STE 2600
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2042
Practice Address - Country:US
Practice Address - Phone:989-775-1662
Practice Address - Fax:989-775-1604
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007891225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist