Provider Demographics
NPI:1770732935
Name:FURNARI, MARISSA LAUREN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:LAUREN
Last Name:FURNARI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:LAUREN
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8 OLD MUSKET LN
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4213
Mailing Address - Country:US
Mailing Address - Phone:631-375-7860
Mailing Address - Fax:
Practice Address - Street 1:8 OLD MUSKET LN
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4213
Practice Address - Country:US
Practice Address - Phone:631-375-7860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022606-1235Z00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174400000XOther Service ProvidersSpecialist