Provider Demographics
NPI:1750706529
Name:MAROUSEK, SHARI LYNN
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:LYNN
Last Name:MAROUSEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:LYNN
Other - Last Name:WILBUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4542 MAHAN CORNER RD
Mailing Address - Street 2:
Mailing Address - City:MARYDEL
Mailing Address - State:DE
Mailing Address - Zip Code:19964-1721
Mailing Address - Country:US
Mailing Address - Phone:302-423-5716
Mailing Address - Fax:
Practice Address - Street 1:4542 MAHAN CORNER RD
Practice Address - Street 2:
Practice Address - City:MARYDEL
Practice Address - State:DE
Practice Address - Zip Code:19964-1721
Practice Address - Country:US
Practice Address - Phone:302-423-5716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist