Basic Information
| Provider Information | |||||||||
| NPI: | 1619064631 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAFFHAUSEN | ||||||||
| FirstName: | MARLA | ||||||||
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| Credential: | O.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 855 SPRINGDALE DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | EXTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193412852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106447824 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 MILL ST | ||||||||
| Address2: | |||||||||
| City: | GAHANNA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432303036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144145437 | ||||||||
| FaxNumber: | 6144140280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 11/26/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | 7220 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 382617193 | 01 | NV | OCCUPATIONAL THERAPIST | OTHER | 382617193 | 01 | OH | OCCUPATIONAL THERAPIST | OTHER |