Provider Demographics
NPI:1790573830
Name:MORALES, MARISSA CASSANDRA (MSED)
Entity type:Individual
Prefix:MISS
First Name:MARISSA
Middle Name:CASSANDRA
Last Name:MORALES
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 DUCKPOND DR N
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-1857
Mailing Address - Country:US
Mailing Address - Phone:516-401-3194
Mailing Address - Fax:516-401-3194
Practice Address - Street 1:63 DUCKPOND DR N
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-1857
Practice Address - Country:US
Practice Address - Phone:516-401-3194
Practice Address - Fax:516-401-3194
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency