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General NPI Number Information
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NPI Number | 1821226879
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Entity Type | Organization
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Legal Business Name | MARJON ENTERPRISES LLC
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 9606 TIERRA GRANDE SUITE 104 / 107
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City | SAN DIEGO
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State | CA
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Zip | 92126-6501
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Country | US
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Telephone | 619-922-6480
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Fax | 866-695-4997
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Provider Business Mailing Address
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Address Line | PO BOX 60325
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City | SAN DIEGO
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State | CA
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Zip | 92166-8325
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Country | US
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Telephone | 619-922-6480
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Fax | 866-695-4997
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. MARJORIE P BLOCK
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Credential | OTR/L
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Telephone | 619-922-6480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | OT 5033
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License Number State | CA
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