Provider Demographics
NPI:1073287462
Name:TOTMAN-MARSHALL, KRISTINA MIAE (RTA)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MIAE
Last Name:TOTMAN-MARSHALL
Suffix:
Gender:F
Credentials:RTA
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:MIAE
Other - Last Name:TOTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RTA
Mailing Address - Street 1:718 SMYTH RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-7007
Mailing Address - Country:US
Mailing Address - Phone:603-624-4366
Mailing Address - Fax:
Practice Address - Street 1:718 SMYTH RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-7007
Practice Address - Country:US
Practice Address - Phone:603-624-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes226000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreational Therapist AssistantGroup - Multi-Specialty