MEDICARE: MISS SHEILA ACOSTA MARQUEZ OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	0838	NV

General Provider Information

NPI Number	:	1003022633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHEILA ACOSTA MARQUEZ OTR

Provider Business Mailing Address
First Line	:	2600 S TOWN CENTER DR
Second Line	:	APT. 1047
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-2064
Country	:	US
Telephone Number	:	775-220-5792
Fax Number	:

Provider Business Practice Location Address
First Line	:	4275 BURNHAM AVE
Second Line	:	STE. 225 DESERT SPRINGS THERAPY CLINIC
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5488
Country	:	US
Telephone Number	:	702-380-1060
Fax Number	:	702-380-1081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	07/08/2007

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