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Individual
MARIANNE PEDERSEN
Active
Individual
MARIANNE PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3406
SC
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH2172
—
SC
Enumeration date
11/02/2009
Last updated
10/17/2011
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