Individual
MARISSA L MASCORRO
Active
Individual
MARISSA L MASCORRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LAC-13710
AZ
101YP2500X
Professional Counselor
LPC-17047
AZ
103TC0700X
Clinical Psychologist
Primary
PSY-005890
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342848
—
AZ
Enumeration date
04/24/2014
Last updated
05/13/2025
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