Provider Demographics
NPI:1114224920
Name:OCHOA, MARISSA (OT)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:OCHOA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 CARLOS ST APT 4
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-6084
Mailing Address - Country:US
Mailing Address - Phone:956-661-0475
Mailing Address - Fax:956-630-9941
Practice Address - Street 1:3300 N MCCOLL RD STE A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5696
Practice Address - Country:US
Practice Address - Phone:956-661-0475
Practice Address - Fax:956-630-9941
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305008225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist