Basic Information
| Provider Information | |||||||||
| NPI: | 1770789539 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRAWITZ | ||||||||
| FirstName: | MARLO | ||||||||
| MiddleName: | FORREST | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | O.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7612 FLORENCE AVE NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871223767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5058215594 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8100 PALOMAS AVE NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871095264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5058360023 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 225X00000X | 2366 | NM | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.