Individual
MARISSA DECESARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3300 HENRY AVE, PHILADELPHIA, PA 19129-1121
(215) 254-2069
Mailing address
700 S 17TH ST APT 201N, PHILADELPHIA, PA 19146-1939
(609) 230-7534
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP017981
PA
Other
Enumeration date
10/13/2017
Last updated
03/17/2018
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