Individual
MARISSA HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 E MAIN ST STE 508, RIVERHEAD, NY 11901-2680
(631) 727-6220
Mailing address
85 DIANA DR, MASTIC BEACH, NY 11951-6308
(631) 258-5097
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
NY
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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