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General NPI Number Information
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NPI Number | 1194241059
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Entity Type | Individual
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Provider Name | MARISSA PERRI GERAGHTY BCBA
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Gender | Female
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 758 N SUN DR STE 112
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City | LAKE MARY
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State | FL
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Zip | 32746-2599
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Country | US
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Telephone | 407-317-5429
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Fax | 321-800-7201
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Provider Business Mailing Address
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Address Line | 1509 E COLONIAL DR STE 300
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City | ORLANDO
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State | FL
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Zip | 32803-4729
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Country | US
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Telephone | 407-317-5429
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Fax | 321-800-7201
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-62247
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License Number State | FL
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