# MARISA GROSS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104800119
- **Gender:** F
- **Credential:** CCC-LSP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | SL005969 L | PA | Yes |
| 235Z00000X | Speech-Language Pathologist | SL005969 L | PA | — |

## Other

- **Enumeration date:** 12/02/2005
- **Last updated:** 07/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0018620480005 | — | PA |
| 01 | — | 1353701 | HIGHMARK | PA |
| 01 | — | 163624 | MEDPLUS | PA |
| 01 | — | 2787821 | AETNA HMO | PA |
| 01 | — | 7064341 | AETNA PPO | PA |
| 01 | — | 819172 | FIRST PRIORITY/BC/BS | PA |
| 01 | — | 9222541 | PHCS | PA |