Most Relevant Information
Provider Data
| NPI Number: | 1003367152 |
| Provider Name: | MARISA ANDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/24/2016 |
| Last Updated: | 01/22/2019 |
Provider Practice Location
1158 MASSACHUSETTS AVE FL 3
CAMBRIDGE
MA
021385205
Practice Location Phone/Fax
| Phone: | 8573140554 |
| Fax: |
Provider Mailing Location
1158 MASSACHUSETTS AVE FL 3
CAMBRIDGE
MA
021385205
Provider Mailing Phone/Fax
| Phone: | 8573140554 |
| Fax: |