Melissa L Blackmon, OT

Individual provider Active NPI Occupational Therapist · Selma, AL

NPI 1356569701 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1356569701
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
1846 (AL)
Practice address
108 Executive Park LN
Selma, AL 36701-7734
Phone
(334) 875-2550
Fax
(334) 875-3654
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1846ALMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1846 AL Yes

Addresses

Primary practice location

108 Executive Park LN
Selma, AL 36701-7734

Mailing address

113 Calvin Cir
Valley Grande, AL 36703-8801
Phone (334) 875-2550

Other providers in Selma, AL

All providers in Selma, AL · Occupational Therapist in Alabama

Sources for this page

Verify at the official NPI Registry.