Provider Demographics
NPI:1477780963
Name:WOOD, MELISSA LYNN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LYNN
Last Name:WOOD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:LYNN
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:29 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARIS
Mailing Address - State:ME
Mailing Address - Zip Code:04281-1516
Mailing Address - Country:US
Mailing Address - Phone:207-739-2021
Mailing Address - Fax:207-739-2188
Practice Address - Street 1:29 PINE ST
Practice Address - Street 2:
Practice Address - City:SOUTH PARIS
Practice Address - State:ME
Practice Address - Zip Code:04281-1516
Practice Address - Country:US
Practice Address - Phone:207-739-2021
Practice Address - Fax:207-739-2188
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT 418225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics