Doctor Name: | MARISSA SALA |
NPI Number: | 1366850422 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | P93914 |
Business Practice Address: | 55 Carleton Ave East Islip, NY - 117302133 |
Business Phone Number: | 6315793503 |
Business Fax Number: | |
Mailing Address: | 52 Engelke Ave, Floor 2 HUNTINGTON STATION |
State: | NY |
Postal Code: | 117463859 |
Phone Number: | 6312781160 |
Fax Number: | |
NPI Enumeration Date: | 07/31/2014 |
NPI Last Update Date: | 01/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | P93914 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |