Provider Demographics
NPI:1952810152
Name:BREWER, MELINDA SUE (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:SUE
Last Name:BREWER
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 MARSEILLES AVE.
Mailing Address - Street 2:
Mailing Address - City:UPPER SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:43351
Mailing Address - Country:US
Mailing Address - Phone:419-294-4973
Mailing Address - Fax:
Practice Address - Street 1:850 MARSEILLES AVE
Practice Address - Street 2:
Practice Address - City:UPPER SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:43351-1648
Practice Address - Country:US
Practice Address - Phone:419-294-4973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008264225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist