Provider Demographics
NPI:1225467566
Name:MITCHEL, MARISSA WEYER (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:WEYER
Last Name:MITCHEL
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:120 HAMM DR
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-7496
Mailing Address - Country:US
Mailing Address - Phone:570-522-9420
Mailing Address - Fax:570-522-9431
Practice Address - Street 1:120 HAMM DR
Practice Address - Street 2:SUITE 2A
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-7496
Practice Address - Country:US
Practice Address - Phone:570-522-9420
Practice Address - Fax:570-522-9431
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
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Provider Licenses
StateLicense IDTaxonomies
PASL009822235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist