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General NPI Number Information
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NPI Number | 1548592868
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Entity Type | Individual
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Provider Name | MARCHETA S NIX OT
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Gender | Female
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 1008 AIRPORT RD SUITE A
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City | DESTIN
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State | FL
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Zip | 32541-2823
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Country | US
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Telephone | 850-837-3349
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Fax | 850-837-3158
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Provider Business Mailing Address
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Address Line | 1153 GULF BREEZE PKWY
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City | GULF BREEZE
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State | FL
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Zip | 32561-7807
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Country | US
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Telephone | 850-932-6382
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Fax | 850-932-9225
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2588
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License Number State | FL
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