Provider Demographics
NPI:1013925742
Name:PICARD, MELISSA S (OTR)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:S
Last Name:PICARD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:245 ALVORD PARK ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-3493
Mailing Address - Country:US
Mailing Address - Phone:860-496-9851
Mailing Address - Fax:860-482-4047
Practice Address - Street 1:245 ALVORD PARK ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3493
Practice Address - Country:US
Practice Address - Phone:860-496-9851
Practice Address - Fax:860-482-4047
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001009225X00000X
CT001008225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist