Provider Demographics
NPI:1740367333
Name:MELANSON, SARAH MEIGS (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MEIGS
Last Name:MELANSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:MEIGS
Other - Last Name:EBELHAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:211 PROSPECT PL
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-2068
Mailing Address - Country:US
Mailing Address - Phone:859-420-3318
Mailing Address - Fax:
Practice Address - Street 1:2412 GREATSTONE PT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3274
Practice Address - Country:US
Practice Address - Phone:859-224-4081
Practice Address - Fax:859-224-4082
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR-3137225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100340640Medicaid
KYKY R-3137OtherOT LICENSE