Provider Demographics
NPI:1821624289
Name:MARSHBURN, ANNA (COTA/L)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MARSHBURN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MACON
Other - Last Name:WEMYSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-3012
Mailing Address - Country:US
Mailing Address - Phone:252-432-6155
Mailing Address - Fax:
Practice Address - Street 1:3836 IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:NC
Practice Address - Zip Code:27525-7011
Practice Address - Country:US
Practice Address - Phone:919-327-0932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13055224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant