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Individual
MISS MARLENE M BASIAGO
Active
Individual
MISS MARLENE M BASIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R./L.,P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006324L
PA
225X00000X
Occupational Therapist
OC000061L
PA
Other
Enumeration date
06/23/2005
Last updated
01/20/2009
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