Provider Demographics
NPI:1689291759
Name:WEBB, MARIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIN
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARIN
Other - Middle Name:
Other - Last Name:LANDRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 W MOORE ST
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2919
Mailing Address - Country:US
Mailing Address - Phone:229-253-8500
Mailing Address - Fax:229-253-8522
Practice Address - Street 1:200 W MOORE ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2919
Practice Address - Country:US
Practice Address - Phone:229-253-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007778225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAOT007778OtherOCCUPATIONAL THERAPY