Most Relevant Information
Provider Data
| NPI Number: | 1003641184 |
| Provider Name: | MARISSA SIECK |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/06/2024 |
| Last Updated: | 09/06/2024 |
Provider Practice Location
3150 CARLISLE BLVD NE STE 105229
ALBUQUERQUE
NM
871101678
Practice Location Phone/Fax
| Phone: | 5056338173 |
| Fax: |
Provider Mailing Location
3150 CARLISLE BLVD NE STE 105229
ALBUQUERQUE
NM
871101678
Provider Mailing Phone/Fax
| Phone: | 5056338173 |
| Fax: |