Provider Demographics
NPI:1932113677
Name:ROBILLARD, MELISSA (OT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ROBILLARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3013 AUTUMN RIDGE DR W
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3224
Mailing Address - Country:US
Mailing Address - Phone:251-753-0491
Mailing Address - Fax:251-990-1494
Practice Address - Street 1:212 HOSPITAL DR STE B
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-2058
Practice Address - Country:US
Practice Address - Phone:251-928-1809
Practice Address - Fax:251-990-1494
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2591225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-34769OtherBLUE CROSS