Marissa Peterson MA/CCC-SLP

NPI 1669633590 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1669633590
Gender Female
Enumeration Date 06/23/2008
Last Updated 07/12/2009
Entity Type Individual
Active Over 9 years ago
Practice Location
IDAHO FALLS ID, 83401-4118, US
Phone (208) 757-8553
Business Location
PO BOX 2943
IDAHO FALLS ID, 83403-2943, US
Phone (208) 757-8553
Fax (208) 524-1929
Taxonomy Code 235Z00000X
License State Idaho
License Number SLP-1685
Remove 1669633590 NPI Number

According to our database, Marissa Peterson MA/CCC-SLP NPI is 1669633590, taxonomy code is 235Z00000X and license number is SLP-1685, license state is located at Idaho. Marissa Peterson MA/CCC-SLP physically located at 545 Lincoln Dr, Idaho Falls ID, 83401-4118. NPI Number Marissa Peterson MA/CCC-SLP has the Individual type.

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1669633590 NPI number is provided on an as is basis without warranty of any kind. 1669633590 is maintained by the National Plan & Provider Enumeration System. The contents of Marissa Peterson MA/CCC-SLP are for informational purposes only.