Individual
CARISSA ROSE MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5920 VAN DOREN ST, CORONA, NY 11368-4018
(718) 592-9200
Mailing address
8112 MARGARET PL, GLENDALE, NY 11385-8045
(718) 872-8666
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
NY
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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