Provider Demographics
NPI:1447351267
Name:MELTON, PATRICIA SUE (OTR)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUE
Last Name:MELTON
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 1:441 HILLCREST LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-5857
Mailing Address - Country:US
Mailing Address - Phone:843-873-7395
Mailing Address - Fax:
Practice Address - Street 1:109 BEE ST
Practice Address - Street 2:117-OT
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-5703
Practice Address - Country:US
Practice Address - Phone:843-789-7666
Practice Address - Fax:843-789-6211
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1360225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist