Provider Demographics
NPI:1598100364
Name:BENDER, MELISSA S (MOTR/L)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:S
Last Name:BENDER
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 11TH ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15027-1638
Mailing Address - Country:US
Mailing Address - Phone:412-706-1060
Mailing Address - Fax:
Practice Address - Street 1:358 11TH ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:PA
Practice Address - Zip Code:15027-1638
Practice Address - Country:US
Practice Address - Phone:412-706-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC012661225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist