Provider Demographics
NPI:1437886207
Name:SPILKER, MELISSA R (COTA/L)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:R
Last Name:SPILKER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:R
Other - Last Name:ULRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:280 INTERSTATE DR.
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385
Mailing Address - Country:US
Mailing Address - Phone:636-327-3800
Mailing Address - Fax:
Practice Address - Street 1:280 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-4510
Practice Address - Country:US
Practice Address - Phone:636-327-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014027295224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant