Healthcare Provider Details

I. General information

NPI: 1710382163
Provider Name (Legal Business Name): MARISA NICOLE SALMERI M.S. - OCCUPATIONAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11143 PARKVIEW PLAZA DR STE 100
FORT WAYNE IN
46845-1728
US

IV. Provider business mailing address

4251 LAHMEYER RD
FORT WAYNE IN
46815-5676
US

V. Phone/Fax

Practice location:
  • Phone: 260-266-7400
  • Fax: 260-266-7439
Mailing address:
  • Phone: 260-432-4700
  • Fax: 260-459-9262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31005766A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: