Provider Demographics
NPI:1801094511
Name:FARRI, MARISA A (COTA)
Entity type:Individual
Prefix:MISS
First Name:MARISA
Middle Name:A
Last Name:FARRI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 SALEM AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6319
Mailing Address - Country:US
Mailing Address - Phone:401-942-9902
Mailing Address - Fax:
Practice Address - Street 1:65 SALEM AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6319
Practice Address - Country:US
Practice Address - Phone:401-942-9902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOTA00023246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI224Z00000XMedicare ID - Type UnspecifiedOCCUPATIONAL THERAPY ASSI