Provider Demographics
NPI:1972836351
Name:GANIER, MARCIE CSEPLO (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARCIE
Middle Name:CSEPLO
Last Name:GANIER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARCIE
Other - Middle Name:ANNE
Other - Last Name:CSEPLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3874 S MILAN WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-3081
Mailing Address - Country:US
Mailing Address - Phone:208-860-0284
Mailing Address - Fax:
Practice Address - Street 1:3874 S MILAN WAY
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-3081
Practice Address - Country:US
Practice Address - Phone:208-860-0284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT-545225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist