Provider Demographics
NPI:1407972789
Name:BLESSING, MARSHA J (COTAL)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:J
Last Name:BLESSING
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 382
Mailing Address - Street 2:40 MAIN STREET
Mailing Address - City:LEWIS RUN
Mailing Address - State:PA
Mailing Address - Zip Code:16738-0382
Mailing Address - Country:US
Mailing Address - Phone:814-362-3954
Mailing Address - Fax:
Practice Address - Street 1:100 SAINT FRANCIS DR
Practice Address - Street 2:REHAB DEPT.
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1868
Practice Address - Country:US
Practice Address - Phone:814-368-5648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP003272-L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant