Provider Demographics
NPI:1023230109
Name:MELROY, MARY KATHERINE (OTR)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:MELROY
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 1:236 CONFEDERATE CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7429
Mailing Address - Country:US
Mailing Address - Phone:843-718-5898
Mailing Address - Fax:
Practice Address - Street 1:236 CONFEDERATE CIR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7429
Practice Address - Country:US
Practice Address - Phone:843-718-5898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4448-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist