| NPI | 1891299798 |
|---|---|
| Former Name | MARISSA GROOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.014241) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2023-03-06 |