Provider Demographics
NPI:1962269779
Name:ARO, MARISSA (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:
Last Name:ARO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:
Other - Last Name:DOWNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15758 WYBURN LN
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-6753
Mailing Address - Country:US
Mailing Address - Phone:904-790-3149
Mailing Address - Fax:
Practice Address - Street 1:16501 WALNUT ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-3641
Practice Address - Country:US
Practice Address - Phone:760-205-3690
Practice Address - Fax:760-657-2408
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health