Individual
MARILOU BASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4492 NE OCEAN BLVD APT C1, JENSEN BEACH, FL 34957-4354
(772) 285-9957
Mailing address
4492 NE OCEAN BLVD APT C1, JENSEN BEACH, FL 34957-4354
(772) 285-9957
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 9616
FL
Other
Enumeration date
12/06/2011
Last updated
09/11/2013
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