Provider Demographics
NPI:1669292199
Name:MELENDEZ, REBEKAH MERCEDES (OTR/L)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:MERCEDES
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6242 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-1028
Mailing Address - Country:US
Mailing Address - Phone:856-952-8428
Mailing Address - Fax:
Practice Address - Street 1:400 S STATE RD STE 220
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-1243
Practice Address - Country:US
Practice Address - Phone:610-356-1991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics