Provider Demographics
NPI:1417545278
Name:QUINN, MARJORIE (COTA)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:QUINN
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 1:503 S TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-8906
Mailing Address - Country:US
Mailing Address - Phone:917-974-7390
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:503 S TIMBER TRL
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-8906
Practice Address - Country:US
Practice Address - Phone:917-974-7390
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA14127224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant