Healthcare Provider Details

I. General information

NPI: 1265347801
Provider Name (Legal Business Name): MARISA MANGINI OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FRIENDSHIP VILLAGE 6000 RIVERSIDE DR
DUBLIN OH
43017
US

IV. Provider business mailing address

2915 ANGELO JOSEPH LANE UNIT 205
COLUMBUS OH
43204
US

V. Phone/Fax

Practice location:
  • Phone: 614-764-1600
  • Fax:
Mailing address:
  • Phone: 614-707-9693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT012037
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: