Individual
MARISSA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
54 OSBORNE ST, STATEN ISLAND, NY 10312-5508
(718) 356-2211
Mailing address
125 CLINTON ST, APT 2, HOBOKEN, NJ 07030-2529
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
016875-1
NY
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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