MEDICARE: MARISSA ANN WINDAU

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
1	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1932970415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA ANN WINDAU

Provider Business Mailing Address
First Line	:	197 N LEAVITT RD
Second Line	:
City	:	AMHERST
State	:	OH
Zip	:	44001-1110
Country	:	US
Telephone Number	:	419-656-8510
Fax Number	:

Provider Business Practice Location Address
First Line	:	197 N LEAVITT RD
Second Line	:
City	:	AMHERST
State	:	OH
Zip	:	44001-1110
Country	:	US
Telephone Number	:	419-656-8510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2024
Last Update Date	:	01/12/2024

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Directions to “ MARISSA ANN WINDAU ” Practice Location

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