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Individual
MARISSA BINGHAM
Active
Individual
MARISSA BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
106H00000X
Marriage & Family Therapist
Primary
T-0177501
NM
106H00000X
Marriage & Family Therapist
—
NULL
Other
Enumeration date
06/30/2014
Last updated
11/11/2015
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