Provider Demographics
NPI:1275819070
Name:CUMMINGS, MARSHELLA L (OTR)
Entity Type:Individual
Prefix:
First Name:MARSHELLA
Middle Name:L
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-3623
Mailing Address - Country:US
Mailing Address - Phone:956-233-5400
Mailing Address - Fax:956-233-5406
Practice Address - Street 1:224 W OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:LOS FRESNOS
Practice Address - State:TX
Practice Address - Zip Code:78566-3623
Practice Address - Country:US
Practice Address - Phone:956-233-5400
Practice Address - Fax:956-233-5406
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111638225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics