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NPI Code Detail

MEDICARE: MARISSA LIPANSKI COTA/L

MEDICARE: MARISSA LIPANSKI COTA/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
1224Z00000XOccupational Therapy Assistant

General Provider Information

NPI Number : 1558919860
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA LIPANSKI COTA/L
Provider Business Mailing Address
First Line : 17001 17 MILE RD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-2801
Country : US
Telephone Number : 586-286-7100
Fax Number :
Provider Business Practice Location Address
First Line : 17001 17 MILE RD # RS
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-2801
Country : US
Telephone Number : 586-286-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2019
Last Update Date : 08/29/2019

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Directions to “ MARISSA LIPANSKI COTA/L” Practice Location

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