Individual
MARISA MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4229 U S HIGHWAY 11, HATTIESBURG, MS 39402-8024
(601) 447-4658
Mailing address
4229 U S HIGHWAY 11, HATTIESBURG, MS 39402-8024
(601) 447-4658
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
25451431
MS
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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