Provider Demographics
NPI:1790533206
Name:FIKE, MARISSA SAIL (MA)
Entity type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:SAIL
Last Name:FIKE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 WALNUT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-5365
Mailing Address - Country:US
Mailing Address - Phone:931-372-7117
Mailing Address - Fax:931-372-7119
Practice Address - Street 1:3380 WALNUT GROVE RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-5365
Practice Address - Country:US
Practice Address - Phone:931-372-7117
Practice Address - Fax:931-372-7119
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health