Provider Demographics
NPI:1487370748
Name:GRABLER, MELISSA SUE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:SUE
Last Name:GRABLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:GRABLER
Other - Last Name:BOISSONNEAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:76 CLEMONS ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3705
Mailing Address - Country:US
Mailing Address - Phone:207-807-6195
Mailing Address - Fax:
Practice Address - Street 1:357 TUTTLE RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND CENTER
Practice Address - State:ME
Practice Address - Zip Code:04021-3625
Practice Address - Country:US
Practice Address - Phone:207-829-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT4141225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist