Most Relevant Information
Provider Data
| NPI Number: | 1003490319 |
| Provider Name: | MARISSA MARIE HALL |
| Entity Type: | Individual |
| Taxonomy Code: | 106E00000X |
| Specialty: | Assistant Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/12/2021 |
| Last Updated: | 05/12/2021 |
Provider Practice Location
1001 LAURENCE AVE
JACKSON
MI
492022979
Practice Location Phone/Fax
| Phone: | 5177504777 |
| Fax: |
Provider Mailing Location
208 SEYMOUR AVE
JACKSON
MI
492023560
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |