Provider Demographics
NPI:1578801643
Name:MELIUS, EMILY (COTA/ L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MELIUS
Suffix:
Gender:F
Credentials:COTA/ L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:SD
Mailing Address - Zip Code:57424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 N HIGHWAY 281
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-1017
Practice Address - Country:US
Practice Address - Phone:605-225-7315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD246A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant