MEDICARE: MARISSA SINGER BCBA

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	103K00000X	Behavior Analyst	1-23-70247	NJ

General Provider Information

NPI Number	:	1467296947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA SINGER BCBA

Provider Business Mailing Address
First Line	:	25 CARRIAGE GATE DR
Second Line	:
City	:	LITTLE SILVER
State	:	NJ
Zip	:	07739-1575
Country	:	US
Telephone Number	:	201-240-8296
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 CARRIAGE GATE DR
Second Line	:
City	:	LITTLE SILVER
State	:	NJ
Zip	:	07739-1575
Country	:	US
Telephone Number	:	201-240-8296
Fax Number	:

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

Provider Enumeration Date	:	06/20/2024
Last Update Date	:	06/20/2024

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