Provider Demographics
NPI:1619470846
Name:MCCABE, MELISSA (COTA/L)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:
Last Name:MCCABE
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 1:115 BEEMER CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07826-5704
Mailing Address - Country:US
Mailing Address - Phone:973-600-8715
Mailing Address - Fax:
Practice Address - Street 1:115 BEEMER CHURCH RD
Practice Address - Street 2:
Practice Address - City:BRANCHVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07826-5704
Practice Address - Country:US
Practice Address - Phone:973-600-8715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09111000224Z00000X
NY008999-01224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant