Provider Demographics
NPI:1831642339
Name:MARSH, ALYSSA L (MOT)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:L
Last Name:MARSH
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:L
Other - Last Name:BRENNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT
Mailing Address - Street 1:166 PATTERSON AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4166
Mailing Address - Country:US
Mailing Address - Phone:908-692-9529
Mailing Address - Fax:
Practice Address - Street 1:166 PATTERSON AVE STE 8
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4166
Practice Address - Country:US
Practice Address - Phone:908-692-9529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00664000225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics