Provider Demographics
NPI:1811295439
Name:RUMSEY, MARISSA (MOTR/L)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:RUMSEY
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BELVEDERE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-7025
Mailing Address - Country:US
Mailing Address - Phone:910-378-6282
Mailing Address - Fax:
Practice Address - Street 1:415 BELVEDERE DR
Practice Address - Street 2:
Practice Address - City:HOLLY RIDGE
Practice Address - State:NC
Practice Address - Zip Code:28445-7025
Practice Address - Country:US
Practice Address - Phone:910-378-6282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-06
Last Update Date:2011-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7645225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist