Individual
MARISSA JANE PAULDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13609 CALIFORNIA ST STE 200, OMAHA, NE 68154-5245
(402) 891-1118
Mailing address
4105 HAWKSMOORE RD, WINSTON SALEM, NC 27106-4281
(336) 924-3380
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2230
NM
Other
Enumeration date
01/17/2008
Last updated
01/17/2008
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