Provider Demographics
NPI:1780833798
Name:MONROE-SHIPMAN, MELISSA LEIGH (OT)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LEIGH
Last Name:MONROE-SHIPMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LEIGH
Other - Last Name:SHIPMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1725 CALHOUN DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-7370
Mailing Address - Country:US
Mailing Address - Phone:501-960-5529
Mailing Address - Fax:
Practice Address - Street 1:2470 COLLEGE AVE.
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034
Practice Address - Country:US
Practice Address - Phone:501-329-5459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2243225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARO-T0853OtherARKANSAS STATE MEDICAL BOARD