Provider Demographics
NPI:1740436682
Name:MAPES, MARISSA REAVIS (MED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:REAVIS
Last Name:MAPES
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 STONY END COURT
Mailing Address - Street 2:THE WOODLANDS
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381
Mailing Address - Country:US
Mailing Address - Phone:919-619-2519
Mailing Address - Fax:919-847-6827
Practice Address - Street 1:10711 KIPP WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099
Practice Address - Country:US
Practice Address - Phone:832-328-1051
Practice Address - Fax:919-847-6827
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist