Provider Demographics
NPI:1841683455
Name:MARINSKI, JESSICA (OTRL)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MARINSKI
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47046 CURTIS RD
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-9223
Mailing Address - Country:US
Mailing Address - Phone:734-355-3447
Mailing Address - Fax:
Practice Address - Street 1:9357 GENERAL DR STE 101
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4666
Practice Address - Country:US
Practice Address - Phone:734-454-1744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-07
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008581225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist