Provider Demographics
NPI:1427434885
Name:CHAPMAN, MELISSIA (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:MELISSIA
Middle Name:
Last Name:CHAPMAN
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 1:3107 LEANNA LN
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-6278
Mailing Address - Country:US
Mailing Address - Phone:870-951-0308
Mailing Address - Fax:
Practice Address - Street 1:3107 LEANNA LN
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-6278
Practice Address - Country:US
Practice Address - Phone:870-951-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A936224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant