Individual
MARISSA MCRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1660 FORT ST, TRENTON, MI 48183-2003
(734) 304-4159
Mailing address
21605 SUPERIOR RD, TAYLOR, MI 48180-4752
(313) 999-9943
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101004909
MI
Other
Enumeration date
11/05/2018
Last updated
07/18/2019
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