Provider Demographics
NPI:1184148835
Name:LAWSON, MELISSA KAYE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:KAYE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:KAYE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:103 LITTLE RIVER LN
Mailing Address - Street 2:
Mailing Address - City:WALHALLA
Mailing Address - State:SC
Mailing Address - Zip Code:29691-3320
Mailing Address - Country:US
Mailing Address - Phone:864-903-9322
Mailing Address - Fax:
Practice Address - Street 1:864 US HIGHWAY 158 BUS W
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:NC
Practice Address - Zip Code:27589-9789
Practice Address - Country:US
Practice Address - Phone:252-257-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9566224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC008650022OtherSOUTH CAROLINA DIVERS LICENSE