Most Relevant Information
Provider Data
| NPI Number: | 1003489766 |
| Provider Name: | MARISSA ROYCE CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/21/2021 |
| Last Updated: | 07/21/2021 |
Provider Practice Location
701 E MAIN ST
HART
MI
494201168
Practice Location Phone/Fax
| Phone: | 2318736026 |
| Fax: |
Provider Mailing Location
316 MORRIS AVE APT 612
MUSKEGON
MI
494401144
Provider Mailing Phone/Fax
| Phone: | 6164460276 |
| Fax: |