Individual
LISA MARIE MARION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT009552L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0053616
AETNA
PA
01
—
0094388000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
06/14/2006
Last updated
07/13/2026
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