Provider Demographics
NPI:1437586849
Name:MELILLO, ROBIN HEATHER (OT)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:HEATHER
Last Name:MELILLO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:HEATHER
Other - Last Name:SILBERBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L; PTA
Mailing Address - Street 1:4650 W SWEETWATER AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1505
Mailing Address - Country:US
Mailing Address - Phone:602-347-2600
Mailing Address - Fax:
Practice Address - Street 1:4650 W SWEETWATER AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1505
Practice Address - Country:US
Practice Address - Phone:602-347-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00111700225200000X
AZ10093A225200000X
AZOTH-010059225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant