Individual
MARISSA PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 W JACKSON ST, WISCONSIN RAPIDS, WI 54495-2702
(715) 421-8840
Mailing address
1116 N POINT DR APT C12, STEVENS POINT, WI 54481-1190
(609) 501-8227
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4718-154
WI
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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