Provider Demographics
NPI:1821401134
Name:DUSMAN, MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:DUSMAN
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 1:10533 WOLF AVE NE
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-8629
Mailing Address - Country:US
Mailing Address - Phone:330-877-4120
Mailing Address - Fax:
Practice Address - Street 1:70 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1911
Practice Address - Country:US
Practice Address - Phone:330-761-1661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH004454174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist