Provider Demographics
NPI:1689257305
Name:HARPE, MARISSA NICHOLE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:NICHOLE
Last Name:HARPE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:MARISSA
Other - Middle Name:NICHOLE
Other - Last Name:VOORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:16134 COMPTON PALMS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1531
Mailing Address - Country:US
Mailing Address - Phone:321-652-0286
Mailing Address - Fax:
Practice Address - Street 1:16134 COMPTON PALMS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1531
Practice Address - Country:US
Practice Address - Phone:321-652-0286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA15570235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist