Provider Demographics
NPI:1104690171
Name:OSTERMAN, MARLA M (COTA)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:M
Last Name:OSTERMAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54389 PINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-5569
Mailing Address - Country:US
Mailing Address - Phone:586-549-1678
Mailing Address - Fax:
Practice Address - Street 1:71150 ORCHARD CROSSING LN
Practice Address - Street 2:
Practice Address - City:ROMEO
Practice Address - State:MI
Practice Address - Zip Code:48065-3644
Practice Address - Country:US
Practice Address - Phone:586-336-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant