Provider Demographics
NPI:1407625627
Name:STOCKER, MARIE LOUISE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:LOUISE
Last Name:STOCKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:MARIE
Other - Middle Name:LOUISE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:411 15TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703-1722
Mailing Address - Country:US
Mailing Address - Phone:330-605-2707
Mailing Address - Fax:
Practice Address - Street 1:807 30TH ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-1404
Practice Address - Country:US
Practice Address - Phone:330-491-0381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.021228225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist