Provider Demographics
NPI:1417456948
Name:ROJAS, MARISSA LILIA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:LILIA
Last Name:ROJAS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 RAMIREZ LN
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-8705
Mailing Address - Country:US
Mailing Address - Phone:956-802-0938
Mailing Address - Fax:
Practice Address - Street 1:17924 SABAL PALM DR STE 3
Practice Address - Street 2:
Practice Address - City:PENITAS
Practice Address - State:TX
Practice Address - Zip Code:78576-0977
Practice Address - Country:US
Practice Address - Phone:956-581-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-10
Last Update Date:2018-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210541224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant