Provider Demographics
NPI:1932777653
Name:MASON, MARISSA ELIZABETH (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:ELIZABETH
Last Name:MASON
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-1324
Mailing Address - Country:US
Mailing Address - Phone:504-201-4430
Mailing Address - Fax:
Practice Address - Street 1:3701 BEHRMAN PL
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-0910
Practice Address - Country:US
Practice Address - Phone:504-367-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist