Provider Demographics
NPI:1750099446
Name:MELNIK, MORGAN SKYLER (COTA/L)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:SKYLER
Last Name:MELNIK
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 1:9559 BUCK HAVEN TRL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-3772
Mailing Address - Country:US
Mailing Address - Phone:850-228-9822
Mailing Address - Fax:
Practice Address - Street 1:9559 BUCK HAVEN TRL
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-3772
Practice Address - Country:US
Practice Address - Phone:850-228-9822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19226224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant