Individual
MARISA WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45 MAIN ST APT 4, SHELBURNE FALLS, MA 01370-1165
(413) 474-0540
Mailing address
45 MAIN ST APT 4, SHELBURNE FALLS, MA 01370-1165
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
532396
MA
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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