Individual
MRS. MARISSA LEIGH KISTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ED.
Contact information
Practice address
4 MEADOWOOD LN, FORT SALONGA, NY 11768-2702
(631) 813-0940
Mailing address
4 MEADOWOOD LN, FORT SALONGA, NY 11768-2702
(631) 813-0940
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
—
—
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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