Individual
MARISSA D BLAKELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 SAW MILL RD, NORTH HALEDON, NJ 07508-2712
(516) 652-0501
Mailing address
101 SAW MILL RD, NORTH HALEDON, NJ 07508-2712
(516) 652-0501
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00749600
NJ
Other
Enumeration date
07/28/2026
Last updated
07/28/2026
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