Individual
MIKKA GRACE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
400 PARKLANE ST, WALBRIDGE, OH 43465-1224
(419) 545-1214
Mailing address
7171 KECK PARK CIR NW, NORTH CANTON, OH 44720-6301
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
008008
OH
224Z00000X
Occupational Therapy Assistant
Primary
OTA008008
OH
Other
Enumeration date
06/15/2021
Last updated
07/03/2023
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