Provider Demographics
NPI:1205115441
Name:O'NEIL, MELISSA NICOLE (OT)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:NICOLE
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 IRENE STREET
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68147-1966
Mailing Address - Country:US
Mailing Address - Phone:402-813-9107
Mailing Address - Fax:
Practice Address - Street 1:300 W MEIGS ST
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:NE
Practice Address - Zip Code:68064-9758
Practice Address - Country:US
Practice Address - Phone:402-359-8687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1599225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist