Individual
MARISA GROSS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CCC-LSP
Contact information
Practice address
851 COMMERCE BLVD, SUITE 107, DICKSON CITY, PA 18519-1677
(570) 489-5561
(570) 489-5563
Mailing address
851 COMMERCE BLVD, SUITE 107, DICKSON CITY, PA 18519-1677
(570) 489-5561
(570) 489-5563
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
SL005969 L
PA
235Z00000X
Speech-Language Pathologist
SL005969 L
PA
Other
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
Enumeration date
12/02/2005
Last updated
09/11/2025
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