Healthcare Provider Details

I. General information

NPI: 1487573499
Provider Name (Legal Business Name): SUZANNE KAYE MARSDEN C.O.T.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 WIGWAM PKWY UNIT 712
HENDERSON NV
89074-2873
US

IV. Provider business mailing address

2925 WIGWAM PKWY UNIT 712
HENDERSON NV
89074-2873
US

V. Phone/Fax

Practice location:
  • Phone: 702-994-1715
  • Fax:
Mailing address:
  • Phone: 702-994-1715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number11-1071
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: