Provider Demographics
NPI:1184814147
Name:CATELL, MELISSA MESERVE (MSOTR/L)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MESERVE
Last Name:CATELL
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 STATE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6623
Mailing Address - Country:US
Mailing Address - Phone:207-942-7630
Mailing Address - Fax:207-942-5686
Practice Address - Street 1:404 STATE ST
Practice Address - Street 2:SUITE 400
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6623
Practice Address - Country:US
Practice Address - Phone:207-942-7630
Practice Address - Fax:207-942-5686
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1804225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME099917OtherANTHEM INDIVIDUAL PROVIDER ID
ME7464888OtherAETNA INDIVIDUAL PROVIDER ID