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NPI Code Detail

MEDICARE: MARISSA LETTINGTON

MEDICARE: MARISSA LETTINGTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-22-62307SD

General Provider Information

NPI Number : 1902305535
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA LETTINGTON
Provider Business Mailing Address
First Line : 1470 INDUSTRIAL DR NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0700
Country : US
Telephone Number : 507-332-7750
Fax Number : 920-857-3366
Provider Business Practice Location Address
First Line : 1470 INDUSTRIAL DR NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0700
Country : US
Telephone Number : 507-322-7750
Fax Number : 920-857-3366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2018
Last Update Date : 11/14/2023

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Directions to “ MARISSA LETTINGTON ” Practice Location

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