Provider Demographics
NPI:1619949732
Name:MARANO, CASEY LEE (OT)
Entity Type:Individual
Prefix:MS
First Name:CASEY
Middle Name:LEE
Last Name:MARANO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:CASEY
Other - Middle Name:
Other - Last Name:SICKLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:2800 E DESERT INN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3608
Mailing Address - Country:US
Mailing Address - Phone:702-294-7499
Mailing Address - Fax:702-734-4901
Practice Address - Street 1:2800 E DESERT INN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3608
Practice Address - Country:US
Practice Address - Phone:702-294-7499
Practice Address - Fax:702-734-4901
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0764225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ100505294Medicaid
NV1619949732OtherNPI NUMBER
NV1619949732Medicaid