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NPI Code Detail

MEDICARE: MRS. ELIZABETH DINN MARSH OTR/L, MS, MOT

MEDICARE: MRS. ELIZABETH DINN MARSH OTR/L, MS, MOT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist112503TX
2225X00000XOccupational Therapist200196LA

General Provider Information

NPI Number : 1013187012
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH DINN MARSH OTR/L, MS, MOT
Provider Business Mailing Address
First Line : 4600 LOCKHILL SELMA RD STE 101
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78249-2186
Country : US
Telephone Number : 210-408-7300
Fax Number : 210-408-7303
Provider Business Practice Location Address
First Line : 4600 LOCKHILL SELMA RD STE 101
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78249-2186
Country : US
Telephone Number : 210-408-7300
Fax Number : 210-408-7303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2008
Last Update Date : 01/08/2014

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