Individual
MS. MARISSA LEE HARFERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
3120 MEMORIAL DR, TWO RIVERS, WI 54241-3229
(715) 891-1405
Mailing address
PO BOX 207, WAUSAU, WI 54402-0207
(715) 891-1405
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
256-140
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256-140
—
WI
Enumeration date
10/16/2018
Last updated
10/16/2018
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