Provider Demographics
NPI:1477734952
Name:FIORE, MELISSA ANN (OTA/L)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:FIORE
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 CUNNINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-1365
Mailing Address - Country:US
Mailing Address - Phone:978-658-4135
Mailing Address - Fax:
Practice Address - Street 1:72 FOREST ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-2825
Practice Address - Country:US
Practice Address - Phone:978-658-4135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2955224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant