Provider Demographics
NPI:1699962647
Name:REEBE, MARISA ANN (MS, CCC-SLP, TSHH)
Entity type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:ANN
Last Name:REEBE
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSHH
Other - Prefix:MISS
Other - First Name:MARISA
Other - Middle Name:ANN
Other - Last Name:CALABRESE, CALABRESE-ROMANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP, TSHH
Mailing Address - Street 1:58 SUMMIT ST
Mailing Address - Street 2:P.S.1
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1832
Mailing Address - Country:US
Mailing Address - Phone:718-984-0960
Mailing Address - Fax:718-984-3389
Practice Address - Street 1:58 SUMMIT ST
Practice Address - Street 2:P.S.1
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-1832
Practice Address - Country:US
Practice Address - Phone:718-984-0960
Practice Address - Fax:718-984-3389
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016148-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist