Healthcare Provider Details

I. General information

NPI: 1356287239
Provider Name (Legal Business Name): DELANEY MARSICEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 5TH AVE S
ESCANABA MI
49829-1201
US

IV. Provider business mailing address

W3175 36.5 MILE ROAD
CARNEY MI
49812
US

V. Phone/Fax

Practice location:
  • Phone: 877-787-3422
  • Fax:
Mailing address:
  • Phone: 906-295-1668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number5202010186
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: