Basic Information
| Provider Information | |||||||||
| NPI: | 1336553973 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHIPMAN | ||||||||
| FirstName: | MELODY | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 68 E BARE HILL RD | ||||||||
| Address2: | |||||||||
| City: | HARVARD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014511848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4022061302 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 ERDMAN WAY | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014531804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785370956 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2014 | ||||||||
| LastUpdateDate: | 06/11/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | 11231 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist |
No ID Information.