Individual
MARISSA D RODRIGUEZ GOMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
192 LAUREL AVE, IRVINGTON, NJ 07111-1331
(559) 903-1953
Mailing address
192 LAUREL AVE, IRVINGTON, NJ 07111-1331
(559) 903-1953
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
126020
NY
104100000X
Social Worker
Primary
44SL07393900
NJ
1041S0200X
School Social Worker
01724051
NJ
1041S0200X
School Social Worker
1933343251
NY
2255A2300X
Athletic Trainer
716767053
NY
2255A2300X
Athletic Trainer
F5340450
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WS72598A
—
NY
Enumeration date
05/05/2021
Last updated
06/09/2026
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