Provider Demographics
NPI:1477295616
Name:YOUNAN, MARISSA JEAN (CGC)
Entity Type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:JEAN
Last Name:YOUNAN
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 BELLE ISLE VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N8S3G7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1224 BELLE ISLE VIEW BLVD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:ONTARIO
Practice Address - Zip Code:N8S3G7
Practice Address - Country:CA
Practice Address - Phone:801-931-6189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS