Most Relevant Information
Provider Data
| NPI Number: | 1003243312 |
| Provider Name: | MARISSA RAE YOUNG SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | SI2224 |
Most Important Dates
| Enumeration Date: | 10/01/2013 |
| Last Updated: | 08/06/2021 |
Provider Practice Location
4715 KIRBY LOOP RD
FORT PIERCE
FL
349815345
Practice Location Phone/Fax
| Phone: | 7725776964 |
| Fax: |
Provider Mailing Location
541 SW FIELDS AVE
PORT ST LUCIE
FL
349534006
Provider Mailing Phone/Fax
| Phone: | 5617296160 |
| Fax: |