Basic Information
| Provider Information | |||||||||
| NPI: | 1972884781 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HORRIGAN | ||||||||
| FirstName: | MELISSA | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 164 LAKE FRONT DR | ||||||||
| Address2: | |||||||||
| City: | HUNT VALLEY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210302215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107853845 | ||||||||
| FaxNumber: | 4107853880 | ||||||||
| Practice Location | |||||||||
| Address1: | 164 LAKE FRONT DR | ||||||||
| Address2: | |||||||||
| City: | HUNT VALLEY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210302215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107853845 | ||||||||
| FaxNumber: | 4107853880 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2011 | ||||||||
| LastUpdateDate: | 09/07/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 06731 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.