Provider Demographics
NPI:1588115927
Name:PACINI, MELANIE L (OTR)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:L
Last Name:PACINI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:L
Other - Last Name:COFFEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:8715 W HIGHWAY 71
Mailing Address - Street 2:APT 5101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8296
Mailing Address - Country:US
Mailing Address - Phone:859-421-9991
Mailing Address - Fax:
Practice Address - Street 1:5524 BEE CAVES RD
Practice Address - Street 2:L
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5245
Practice Address - Country:US
Practice Address - Phone:512-327-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117598225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist