Provider Demographics
NPI:1972087633
Name:SCIABARRA, MARISSA LEE
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:LEE
Last Name:SCIABARRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9130 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6438
Mailing Address - Country:US
Mailing Address - Phone:443-537-7149
Mailing Address - Fax:
Practice Address - Street 1:9130 WINDING WAY
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6438
Practice Address - Country:US
Practice Address - Phone:443-537-7149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer