Provider Demographics
NPI:1619212784
Name:GALBREATH, MELISSA SUSAN (MS, OTR)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:SUSAN
Last Name:GALBREATH
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1358
Mailing Address - Country:US
Mailing Address - Phone:732-859-1119
Mailing Address - Fax:
Practice Address - Street 1:368 LAKEHURST RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-7339
Practice Address - Country:US
Practice Address - Phone:888-244-5373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00597900225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist