Individual
MARISSA JEREE SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS,BA,CC
Contact information
Practice address
102 W CLIPPER ST, KENNETT, MO 63857-1910
(573) 559-6404
Mailing address
102 W CLIPPER ST, KENNETT, MO 63857-1910
(573) 559-6404
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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