Provider Demographics
NPI:1114476645
Name:BISCEGLIE, MARLA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:BISCEGLIE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARLA
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:7265 SW JUNIPER TER
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5102
Mailing Address - Country:US
Mailing Address - Phone:609-420-5392
Mailing Address - Fax:
Practice Address - Street 1:1900 FULTON ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1806
Practice Address - Country:US
Practice Address - Phone:503-538-2108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR312178225X00000X
TX116643225X00000X
NJ46TR00627100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist