| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MARISSA VAVRA | 1821697392 | 2022-02-24 |
Marissa Vavra is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1821697392. Registration indicates Marissa Vavra is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Occupational Therapist (Occupational Therapist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Marissa Vavra OTD |
| Practice Office Address | 1405 N HUNT CLUB RD GURNEE, IL US |
| Practice Office Telephone | 8478552890 |
| Mailing Address | 18W108 CLAREMONT DR DARIEN, IL 605615702 US |
| EMR system [] | Epic | Health Information Exchange (HIE) |
| Code | Practice | License No State |
|---|---|---|
| 225X00000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapist Occupational Therapist Speech/Occupational/Physical Therapy/Chiropractor Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 056.013736
IL |