Provider Demographics
NPI:1639618176
Name:PAIVA, MARINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:PAIVA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 HILL STREET
Mailing Address - Street 2:
Mailing Address - City:1351 SOUTH COUNTY TRAIL
Mailing Address - State:RI
Mailing Address - Zip Code:02818-4226
Mailing Address - Country:US
Mailing Address - Phone:401-886-4650
Mailing Address - Fax:401-886-7084
Practice Address - Street 1:1351 SOUTH COUNTY TRAIL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-4226
Practice Address - Country:US
Practice Address - Phone:401-886-4650
Practice Address - Fax:401-886-7084
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01548225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist