Individual
MARISSA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
38 BAILEY ST, DORCHESTER, MA 02124-3737
(617) 721-1553
Mailing address
38 BAILEY ST, DORCHESTER, MA 02124-3737
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
11301
MA
225X00000X
Occupational Therapist
Primary
117551
TX
Other
Enumeration date
05/05/2016
Last updated
05/05/2016
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