Provider Demographics
NPI:1851868715
Name:DECKER, MELINDA RICHARDS (OTR/L, MSOT)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:RICHARDS
Last Name:DECKER
Suffix:
Gender:F
Credentials:OTR/L, MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 4TH AVE S STE 210
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-2204
Mailing Address - Country:US
Mailing Address - Phone:205-541-0120
Mailing Address - Fax:205-325-1181
Practice Address - Street 1:2124 4TH AVE S STE 210
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2204
Practice Address - Country:US
Practice Address - Phone:205-939-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2002225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist