Provider Demographics
NPI:1427332329
Name:PECINA, MARISSA MARIE (SLP)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:MARIE
Last Name:PECINA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 FAIRMONT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6498
Mailing Address - Country:US
Mailing Address - Phone:956-661-0475
Mailing Address - Fax:956-661-0482
Practice Address - Street 1:7007 N 10TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3104
Practice Address - Country:US
Practice Address - Phone:956-661-0475
Practice Address - Fax:956-661-0482
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist