Provider Demographics
NPI:1629713847
Name:WHITE, MARISA SCHIFF (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:SCHIFF
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:JILL
Other - Last Name:SCHIFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:10170 CHURCH RANCH WAY UNIT 125
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6073
Mailing Address - Country:US
Mailing Address - Phone:720-706-3396
Mailing Address - Fax:
Practice Address - Street 1:10170 CHURCH RANCH WAY UNIT 125
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-6073
Practice Address - Country:US
Practice Address - Phone:720-706-3396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0004856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist