Provider Demographics
NPI:1841671260
Name:ROLLING, MARJORIE ALICE
Entity type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:ALICE
Last Name:ROLLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1681 SPRINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-3727
Mailing Address - Country:US
Mailing Address - Phone:808-348-0279
Mailing Address - Fax:
Practice Address - Street 1:1681 SPRINGWOOD DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-3727
Practice Address - Country:US
Practice Address - Phone:808-348-0279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist