Individual
MARISSA ROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, BCBA
Contact information
Practice address
2620 FORUM BLVD STE E, COLUMBIA, MO 65203-5454
(573) 680-0439
Mailing address
4855 W EAST RIDGE RD, COLUMBIA, MO 65202-7179
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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