Individual
MARISSA STOCKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 S 6TH AVE, TUCSON, AZ 85723-3289
(520) 792-1450
Mailing address
3601 S 6TH AVE # 11-116G, TUCSON, AZ 85723-0001
(520) 792-1450
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
149020647
IL
Other
Enumeration date
07/20/2016
Last updated
10/04/2018
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