Provider Demographics
NPI:1255463428
Name:HOARD, MARIANNA P (OTR)
Entity type:Individual
Prefix:MRS
First Name:MARIANNA
Middle Name:P
Last Name:HOARD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 N SLEEPY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-1243
Mailing Address - Country:US
Mailing Address - Phone:414-228-9199
Mailing Address - Fax:
Practice Address - Street 1:10995 N MARKET ST
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-4952
Practice Address - Country:US
Practice Address - Phone:262-478-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2081-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist