| NPI | 1558681932 |
|---|---|
| Former Name | MARISSA JADE HULSEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AL 5395) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AL PTA 4888) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2021-07-15 |