Individual
MARISSA GABRIELLE KOMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1820 85TH ST, KENOSHA, WI 53143-6426
(262) 371-5030
Mailing address
1820 85TH ST, KENOSHA, WI 53143-6426
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/07/2025
Last updated
08/07/2025
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