Provider Demographics
NPI:1376887810
Name:SNEATH, MELISSA ANN (COTA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:SNEATH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 W 40TH ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2116
Mailing Address - Country:US
Mailing Address - Phone:410-243-7699
Mailing Address - Fax:443-524-2108
Practice Address - Street 1:830 W 40TH ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2116
Practice Address - Country:US
Practice Address - Phone:410-243-7699
Practice Address - Fax:443-524-2108
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA01524224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant