Provider Demographics
NPI:1447084660
Name:MORROW, MARISSA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:MORROW
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 SUGAR MAPLE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-4005
Mailing Address - Country:US
Mailing Address - Phone:248-701-6772
Mailing Address - Fax:
Practice Address - Street 1:303 SHARP RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-1481
Practice Address - Country:US
Practice Address - Phone:410-479-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11208235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist