Provider Demographics
NPI:1679328181
Name:CLIFT, MELINDA LAJUANA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:LAJUANA
Last Name:CLIFT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 WRANGLER LN
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-2963
Mailing Address - Country:US
Mailing Address - Phone:615-668-4396
Mailing Address - Fax:
Practice Address - Street 1:2744 ASHERS FORK DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-4943
Practice Address - Country:US
Practice Address - Phone:615-895-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3814225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist