Provider Demographics
NPI:1952641078
Name:LUDWIG, MELISSA SUE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:SUE
Last Name:LUDWIG
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 1:2265 HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:17889-8727
Mailing Address - Country:US
Mailing Address - Phone:570-743-6001
Mailing Address - Fax:
Practice Address - Street 1:2265 HOLLOW RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:PA
Practice Address - Zip Code:17889-8727
Practice Address - Country:US
Practice Address - Phone:570-743-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005901L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist