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General NPI Number Information
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NPI Number | 1144488677
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Entity Type | Individual
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Provider Name | MARISSA D'AGOSTINO PENDLEY MS/CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/31/2008
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 800 MEADOWLAND DR UNIT E
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City | NAPLES
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State | FL
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Zip | 34108-2531
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Country | US
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Telephone | 239-431-7305
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Fax |
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Provider Business Mailing Address
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Address Line | 6561 CHESTNUT CIR
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City | NAPLES
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State | FL
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Zip | 34109-7811
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Country | US
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Telephone | 239-248-0458
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Fax | 239-316-4525
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP004536
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA 4153
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License Number State | FL
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