National Provider Identifier
Marissa Nicole Peters
Marissa Nicole Peters is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Fairport, NY and a listed phone number of (609) 468-2835.
Profile Overview
- NPI
- 1073046793
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- April 10, 2017
- Last Updated
- November 09, 2020
Practice Location
- 36 Boxwood Ln Apt 11
- Fairport, NY 14450-3779
Phone: (609) 468-2835
Mailing Address
- 36 Boxwood Ln
- Apt. 11
- Fairport, NY 14450-3777
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1073046793
- Entity Type
- Individual
- Last Name
- Peters
- First Name
- Marissa
- Middle Name
- Nicole
- Mailing Street Address
- 36 Boxwood Ln
- Mailing Address Line 2
- Apt. 11
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-3777
- Mailing Country
- US
- Practice Street Address
- 36 Boxwood Ln Apt 11
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-3779
- Practice Country
- US
- Practice Phone
- (609) 468-2835
- Enumeration Date
- April 10, 2017
- Last Updated
- November 09, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- October 07, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)