Provider Demographics
NPI:1245562602
Name:BRIZGIS, MELISSA ANN (OT/L, MS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:BRIZGIS
Suffix:
Gender:F
Credentials:OT/L, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 E DRY CREEK RD UNIT 524
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2780
Mailing Address - Country:US
Mailing Address - Phone:940-300-4357
Mailing Address - Fax:
Practice Address - Street 1:620 WILCOX ST
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1730
Practice Address - Country:US
Practice Address - Phone:940-300-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0003063225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics