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Individual

MARISSA A KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7591 TYLERS PLACE BLVD, WEST CHESTER, OH 45069-6308
(513) 755-6600
(513) 755-3762
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 294-4050
(513) 755-3762

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA007040
OH
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0406425
OH
01
AB7360731
MEDICARE PIN
OH
Enumeration date
09/26/2017
Last updated
01/27/2023
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