Provider Demographics
NPI:1619064631
Name:PAFFHAUSEN, MARLA (OT)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:PAFFHAUSEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 SPRINGDALE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2852
Mailing Address - Country:US
Mailing Address - Phone:610-644-7824
Mailing Address - Fax:
Practice Address - Street 1:170 MILL ST
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3036
Practice Address - Country:US
Practice Address - Phone:614-414-5437
Practice Address - Fax:614-414-0280
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7220225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV382617193OtherOCCUPATIONAL THERAPIST
OH382617193OtherOCCUPATIONAL THERAPIST