Provider Demographics
NPI:1164268082
Name:BROWN, MELANIE (OTR)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:BROWN
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 1:409 N OAK ST STE 220
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-6312
Mailing Address - Country:US
Mailing Address - Phone:682-502-4440
Mailing Address - Fax:682-502-4490
Practice Address - Street 1:409 N OAK ST STE 220
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-6312
Practice Address - Country:US
Practice Address - Phone:682-502-4440
Practice Address - Fax:682-502-4490
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110715225X00000X, 225XN1300X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation