| NPI | 1598142135 |
|---|---|
| Former Name | MARISSA DEFEDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040029) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 10242) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2018-05-22 |