Provider Demographics
NPI:1659941946
Name:ONEAL, MELANIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:ONEAL
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 1:4809 NEWTON DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-6703
Mailing Address - Country:US
Mailing Address - Phone:190-192-1127
Mailing Address - Fax:
Practice Address - Street 1:4809 NEWTON DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38109-6703
Practice Address - Country:US
Practice Address - Phone:901-921-1271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2825224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant