Provider Demographics
NPI:1669450995
Name:ERDMAN-GRAYBILL, MELISSA ARIANNE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ARIANNE
Last Name:ERDMAN-GRAYBILL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9603 N DITZLER CT
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-7747
Mailing Address - Country:US
Mailing Address - Phone:816-781-0615
Mailing Address - Fax:
Practice Address - Street 1:9603 N DITZLER CT
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64157-7747
Practice Address - Country:US
Practice Address - Phone:816-781-0615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005195225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist