Individual
MARSHA LANDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
10 PALMER ST, LEBANON, PA 17042-9734
(717) 279-7817
Mailing address
10 PALMER ST, LEBANON, PA 17042-9734
(717) 279-7817
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP002121L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP002121L
STATE LICENSE
PA
Enumeration date
02/22/2008
Last updated
02/22/2008
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