Provider Demographics
NPI:1700990611
Name:JONES, MELISSA WILDE (PHD, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:WILDE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD, OTR/L
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:WILDE
Other - Last Name:SINNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, OTR/L
Mailing Address - Street 1:2511 FOREST GLEN RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1129
Mailing Address - Country:US
Mailing Address - Phone:785-341-4119
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED ARMY MEDICAL CENTER, ATTN: OCCUP. THERAPY
Practice Address - Street 2:6900 GEORGIA AVE, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-5001
Practice Address - Country:US
Practice Address - Phone:202-782-6374
Practice Address - Fax:202-782-4639
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01150225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand