Individual
MARISSA LOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
851 4TH AVE E, DICKINSON, ND 58601-4014
(701) 456-7242
Mailing address
851 4TH AVE E, DICKINSON, ND 58601-4014
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1384
ND
Other
Enumeration date
03/16/2017
Last updated
03/16/2017
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