Provider Demographics
NPI:1881568566
Name:GAMBINA, MARIE (COTA/L)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:GAMBINA
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 SAINT CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:LA
Mailing Address - Zip Code:70079-2359
Mailing Address - Country:US
Mailing Address - Phone:504-621-3038
Mailing Address - Fax:
Practice Address - Street 1:425 SAINT CHARLES ST
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:LA
Practice Address - Zip Code:70079-2359
Practice Address - Country:US
Practice Address - Phone:504-621-3038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332598225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty