Provider Demographics
NPI:1326737461
Name:RODRIGUES-CORREIA, MARISSA DANIELA
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:DANIELA
Last Name:RODRIGUES-CORREIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MARLBOROUGH ST
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-2910
Mailing Address - Country:US
Mailing Address - Phone:781-632-0835
Mailing Address - Fax:
Practice Address - Street 1:85 MARLBOROUGH ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2910
Practice Address - Country:US
Practice Address - Phone:781-632-0835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health