Provider Demographics
NPI:1669594503
Name:SUNDQUIST, MARNI JEAN (OTR)
Entity type:Individual
Prefix:
First Name:MARNI
Middle Name:JEAN
Last Name:SUNDQUIST
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 1:112BOWER LANE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050
Mailing Address - Country:US
Mailing Address - Phone:410-420-9666
Mailing Address - Fax:
Practice Address - Street 1:112 BOWER LN
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-1749
Practice Address - Country:US
Practice Address - Phone:410-420-9666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02427225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist