Provider Demographics
NPI:1174888192
Name:DICKEY, MELANIE NICOLE (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:NICOLE
Last Name:DICKEY
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-1030
Mailing Address - Country:US
Mailing Address - Phone:402-362-0436
Mailing Address - Fax:
Practice Address - Street 1:2222 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-1030
Practice Address - Country:US
Practice Address - Phone:402-362-0436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NE901014225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist