Healthcare Provider Details

I. General information

NPI: 1992610166
Provider Name (Legal Business Name): CAROLINE W MARSO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 S NEWTOWN RD
NORFOLK VA
23502-5718
US

IV. Provider business mailing address

4720 BIRDSONG LN APT 416
VIRGINIA BEACH VA
23455-1888
US

V. Phone/Fax

Practice location:
  • Phone: 757-427-4700
  • Fax:
Mailing address:
  • Phone: 360-907-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number0131003205
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: