Individual
MARISSA JANE RODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
55 HERITAGE WAY, KALISPELL, MT 59901-3100
(406) 471-9910
(406) 309-2076
Mailing address
500 12TH AVE W STE 2A, COLUMBIA FALLS, MT 59912-3855
(406) 471-1117
(406) 309-2076
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0007132
CO
225XP0200X
Pediatric Occupational Therapist
Primary
9466
MT
Other
Enumeration date
11/07/2021
Last updated
12/29/2022
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