Provider Demographics
NPI:1164946893
Name:YAHIL, MARISSA LYNN
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:LYNN
Last Name:YAHIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:LYNN
Other - Last Name:CECALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17430 CAMPBELL RD STE 107
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5297
Mailing Address - Country:US
Mailing Address - Phone:214-892-2968
Mailing Address - Fax:
Practice Address - Street 1:17430 CAMPBELL RD STE 107
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5297
Practice Address - Country:US
Practice Address - Phone:214-892-2968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist