Provider Demographics
NPI:1053974600
Name:MORROW, MELISSA ANN (COTA/L)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:MORROW
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 N SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PULASKI
Mailing Address - State:IL
Mailing Address - Zip Code:62548-1049
Mailing Address - Country:US
Mailing Address - Phone:217-572-3245
Mailing Address - Fax:
Practice Address - Street 1:1120 N TOPPER DR
Practice Address - Street 2:
Practice Address - City:MOUNT PULASKI
Practice Address - State:IL
Practice Address - Zip Code:62548-1499
Practice Address - Country:US
Practice Address - Phone:217-792-3218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant