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NPI Code Detail

MEDICARE: MARISSA RITTER

MEDICARE: MARISSA RITTER
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLAAC-15556AZ

General Provider Information

NPI Number : 1023977014
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA RITTER
Provider Business Mailing Address
First Line : 720 E MONTEBELLO AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-2543
Country : US
Telephone Number : 602-279-1468
Fax Number :
Provider Business Practice Location Address
First Line : 720 E MONTEBELLO AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-2543
Country : US
Telephone Number : 602-279-1468
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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Directions to “ MARISSA RITTER ” Practice Location

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