Provider Demographics
NPI:1750822516
Name:ROBERT, MARRA ISABELLA (OTD)
Entity Type:Individual
Prefix:DR
First Name:MARRA
Middle Name:ISABELLA
Last Name:ROBERT
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 W GEORGE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4314
Mailing Address - Country:US
Mailing Address - Phone:734-474-4016
Mailing Address - Fax:
Practice Address - Street 1:1118 W GEORGE ST APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4314
Practice Address - Country:US
Practice Address - Phone:734-474-4016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics