Provider Demographics
NPI:1013306315
Name:HARMAN, MELISSA LYNN (PT)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LYNN
Last Name:HARMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 E WILLOW ST UNIT 109
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-6320
Mailing Address - Country:US
Mailing Address - Phone:714-299-7053
Mailing Address - Fax:
Practice Address - Street 1:2514 E WILLOW ST UNIT 109
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-6320
Practice Address - Country:US
Practice Address - Phone:714-299-7053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17124225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist