Provider Demographics
NPI:1588811749
Name:PEIFER, MARISSA LYNNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:LYNNE
Last Name:PEIFER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 NAPLES RD
Mailing Address - Street 2:APT 1
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5729
Mailing Address - Country:US
Mailing Address - Phone:781-363-1812
Mailing Address - Fax:
Practice Address - Street 1:185 DEVONSHIRE ST
Practice Address - Street 2:SUITE 803
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1407
Practice Address - Country:US
Practice Address - Phone:617-259-1895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist