Doctor Name: | MARISSA GENE STITT |
NPI Number: | 1982002721 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LPC |
License Number: | 01619 |
Business Practice Address: | 214 Chandler Ave Eveleth, MN - 557341675 |
Business Phone Number: | 2184714327 |
Business Fax Number: | 2187449632 |
Mailing Address: | Po Box 1188, VIRGINIA |
State: | MN |
Postal Code: | 557921188 |
Phone Number: | 2187492881 |
Fax Number: | 2187493806 |
NPI Enumeration Date: | 12/10/2014 |
NPI Last Update Date: | 12/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 01619 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |