Provider Demographics
NPI:1952865578
Name:MOUSER, MELISSA NICOLE (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:NICOLE
Last Name:MOUSER
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 1:103 WATSON TRL
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-8475
Mailing Address - Country:US
Mailing Address - Phone:724-371-7613
Mailing Address - Fax:
Practice Address - Street 1:900 3RD AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-4613
Practice Address - Country:US
Practice Address - Phone:724-846-8504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT010252225X00000X
PAOC015834225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist