Individual
SUSAN MARISSA ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3488 JEFFCO BLVD STE 102, ARNOLD, MO 63010-6015
(636) 464-5439
Mailing address
3 S CANE ST APT 11, ELLSINORE, MO 63937-8237
(928) 897-2726
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2025019615
MO
Other
Enumeration date
05/31/2017
Last updated
09/23/2025
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