Individual
MICHELLE MARIE MARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
2332 2275TH AVE, ATLANTA, IL 61723-9000
(217) 638-8822
(217) 648-2549
Mailing address
2332 2275TH AVE, ATLANTA, IL 61723-9000
(217) 638-8822
(217) 648-2549
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MM67660801P
IL
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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