Individual
KNEKA NICOLLE MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
6264 FERRIS SQ, SAN DIEGO, CA 92121-3204
(619) 940-4128
Mailing address
11585 TRAILBRUSH PT, SAN DIEGO, CA 92126-8001
(909) 693-1779
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
26366
CA
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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