Provider Demographics
NPI:1306967369
Name:SNODGRASS, MARLA GAY (COTA)
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:GAY
Last Name:SNODGRASS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:506 CATHERINE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-9480
Mailing Address - Country:US
Mailing Address - Phone:828-894-0246
Mailing Address - Fax:828-894-0246
Practice Address - Street 1:200 FORTRESS DR
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:SC
Practice Address - Zip Code:29349-9160
Practice Address - Country:US
Practice Address - Phone:864-599-8552
Practice Address - Fax:864-814-1358
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1402224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant