Provider Demographics
NPI:1932232303
Name:BURKHART, MELISSA A (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:BURKHART
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6222 CLIFFSIDE TER
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5878
Mailing Address - Country:US
Mailing Address - Phone:301-873-8459
Mailing Address - Fax:
Practice Address - Street 1:56 W FREDERICK ST
Practice Address - Street 2:
Practice Address - City:WALKERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21793-8254
Practice Address - Country:US
Practice Address - Phone:301-898-4320
Practice Address - Fax:301-898-4343
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04970225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist