Melinda Rose Fagan, M.S.

NPI #1225172570 in La Grange, Illinois

Provider Information

NPI Number: 1225172570
Entity Type: Individual
Name: Melinda Rose Fagan, M.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: M.S.
Enumeration Date: Feb 19, 2007
Last Updated: Sep 20, 2019

Practice Location

Address: 1301 W COSSITT AVE
City: La Grange
State: Illinois
ZIP Code: 60525-2145
Phone: (708) 354-5730

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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