Provider Demographics
NPI:1851007876
Name:CONLEY, MELISSA (OT/L)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CONLEY
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45656-1068
Mailing Address - Country:US
Mailing Address - Phone:740-250-3629
Mailing Address - Fax:
Practice Address - Street 1:205 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:OH
Practice Address - Zip Code:45656-1068
Practice Address - Country:US
Practice Address - Phone:740-250-3629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3033225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics