Marissa Larson, COTA/L

NPI 1366954653 · on the registry since 2017 · sole proprietor

Practice

Address: 1000 Stacie Dr
Hazleton, PA 18201
Phone: (570) 453-5100
Organisation at this address: Op Hazleton Ii, Llc
1000 Stacie Drive Opco Llc
Pavilion At St. Luke Village Facility Operations, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 16

Registry record

Primary taxonomy: 224Z00000X
224Z00000X
Licence states on file: PA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2017-10-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania