MEDICARE: MARISSA LEE D'ALFONSO

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
1	235Z00000X	Speech-Language Pathologist	7101009372	MI

General Provider Information

NPI Number	:	1235863713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA LEE D'ALFONSO

Provider Business Mailing Address
First Line	:	43599 SCHOENHERR RD STE 100
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-1177
Country	:	US
Telephone Number	:	586-884-3621
Fax Number	:	248-726-2288

Provider Business Practice Location Address
First Line	:	43599 SCHOENHERR RD STE 100
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-1177
Country	:	US
Telephone Number	:	586-884-3621
Fax Number	:	248-726-2288

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	05/12/2025

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Directions to “ MARISSA LEE D'ALFONSO ” Practice Location

Language	Start Address	Practice Location

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