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Individual

MS. JILL MARMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
6305 CORTEZ RD W, BRADENTON, FL 34210-2604
(941) 761-3499
Mailing address
6305 CORTEZ RD W, BRADENTON, FL 34210-2604
(941) 761-3499

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10528
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTA10528
FLORIDA
FL
Enumeration date
01/10/2012
Last updated
01/10/2012
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