Provider Demographics
NPI:1902039415
Name:JAMES, MARLA JEAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:JEAN
Last Name:JAMES
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 1:4520 BELLALUNA DR
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3100
Mailing Address - Country:US
Mailing Address - Phone:605-484-5260
Mailing Address - Fax:
Practice Address - Street 1:1395 N COURTENAY PKWY STE 102
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4474
Practice Address - Country:US
Practice Address - Phone:321-986-8812
Practice Address - Fax:321-986-8814
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1429225X00000X
IA001944225X00000X
SD0749225X00000X
FLOT20500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist