Individual
MARISSA VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15850 CRABBS BRANCH WAY # 150, ROCKVILLE, MD 20855-2622
(301) 869-7505
Mailing address
9916 SHELBURNE TER APT 202, GAITHERSBURG, MD 20878-5323
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
02327L
MD
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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