Provider Demographics
NPI:1255610655
Name:MOLINA, MARLA G (OTL)
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:G
Last Name:MOLINA
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:SANCHEZ CASTANO AVE., 35 BLOCK, VILLA CAROLINA
Mailing Address - Street 2:#21
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-752-1979
Mailing Address - Fax:787-276-6299
Practice Address - Street 1:SANCHEZ CASTANO AVE., 35 BLOCK, VILLA CAROLINA
Practice Address - Street 2:#21
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-752-1979
Practice Address - Fax:787-276-6299
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR1004225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist