Provider Demographics
NPI:1487739538
Name:MARSCOLA, SHONA R (OTR)
Entity type:Individual
Prefix:
First Name:SHONA
Middle Name:R
Last Name:MARSCOLA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4527 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3105
Mailing Address - Country:US
Mailing Address - Phone:832-693-9450
Mailing Address - Fax:
Practice Address - Street 1:2600 GESSNER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-3839
Practice Address - Country:US
Practice Address - Phone:713-690-7069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110411225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4784OtherBCBS OF TEXAS