Most Relevant Information
Provider Data
| NPI Number: | 1003216490 |
| Provider Name: | MARISSA LEAH CONNELLY LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 0 |
Most Important Dates
| Enumeration Date: | 09/04/2014 |
| Last Updated: | 11/30/2017 |
Provider Practice Location
148 WILSON AVE
BROOKLYN
NY
112378042
Practice Location Phone/Fax
| Phone: | 6466604177 |
| Fax: |
Provider Mailing Location
148 WILSON AVE
BROOKLYN
NY
112378042
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |