Individual
MARISSA AXLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7016 CORPORATE WAY, DAYTON, OH 45459-4300
(937) 951-2084
Mailing address
2306 POLO PARK DR, DAYTON, OH 45439-3271
(517) 574-8557
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-26-87825
OH
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/11/2020
Last updated
03/27/2026
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