Provider Demographics
NPI:1922573443
Name:MARNIE ADAMSON, OTR, LLC
Entity Type:Organization
Organization Name:MARNIE ADAMSON, OTR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THEARPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:510-866-1295
Mailing Address - Street 1:5675 SLICK ROCK CT
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3551
Mailing Address - Country:US
Mailing Address - Phone:510-866-1295
Mailing Address - Fax:
Practice Address - Street 1:5125 UTE HWY
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-9128
Practice Address - Country:US
Practice Address - Phone:510-866-1295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty