Individual
MARISSA SHAWNTELL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1646 N LITCHFIELD RD STE B105, GOODYEAR, AZ 85395-1203
(623) 935-6040
Mailing address
3502 N 300TH DR, BUCKEYE, AZ 85396-2129
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
14453981
AZ
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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