Provider Demographics
NPI:1922714013
Name:KESSLER, MARISSA (MS, EDS)
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:MS, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6740 CROSSWINDS DR N STE L
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8606
Mailing Address - Country:US
Mailing Address - Phone:727-599-3624
Mailing Address - Fax:
Practice Address - Street 1:6740 CROSSWINDS DR N STE L
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8606
Practice Address - Country:US
Practice Address - Phone:727-599-3624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS1213103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool