Provider Demographics
NPI:1346652393
Name:MEADOWS, MELVINA JEAN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:MELVINA
Middle Name:JEAN
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:MELVINA
Other - Middle Name:
Other - Last Name:GILMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:507 CAPITOL CT NE STE 100
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7705
Mailing Address - Country:US
Mailing Address - Phone:434-509-7798
Mailing Address - Fax:
Practice Address - Street 1:507 CAPITOL CT NE STE 100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7705
Practice Address - Country:US
Practice Address - Phone:434-509-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X, 225XP0200X
DCOT010000992225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist