MEDICARE: MARCIE MARINELLI FOLGER OTR/L

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	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1275380198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIE MARINELLI FOLGER OTR/L

Provider Business Mailing Address
First Line	:	4241 KING VALLEY DR SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-4224
Country	:	US
Telephone Number	:	205-478-6822
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 VILLAGE GREEN CIR SE UNIT 201A
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-3476
Country	:	US
Telephone Number	:	404-465-2399
Fax Number	:

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

Provider Enumeration Date	:	04/30/2024
Last Update Date	:	04/30/2024

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