Provider Demographics
NPI:1437333416
Name:DAVRET, MARILYN C (MA, OTR)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:C
Last Name:DAVRET
Suffix:
Gender:F
Credentials:MA, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 URSULA DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3023
Mailing Address - Country:US
Mailing Address - Phone:516-287-7159
Mailing Address - Fax:
Practice Address - Street 1:116 URSULA DR
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-3023
Practice Address - Country:US
Practice Address - Phone:516-287-7159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001906225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist