Elder, Marissa

Elder, Marissa is an individual health care provider with primary practice located at 12355 W Cocopah St , Avondale AZ 85323-3120. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Elder, Marissa can be contacted via phone (717) 261-7319.

Contact Information

Primary practice address
12355 W Cocopah St Avondale AZ 85323-3120
Phone: (717) 261-7319
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 6720 Arizona

Profile Details

NPI number 1386186468
LBN Legal business name Elder, Marissa
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2016
Last updated Nov 7th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386186468 NPPES
Arizona Other 6720 AZ BOARD OF OT LICENSE

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