Marissa Brianna Garvich, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9394 Issued in MN

Practice address

1309 Oak Ave
Suite 210
Waconia, MN 55387-1078

Phone

(952) 223-2506

Fax

(952) 443-2038

NPI assigned

Jan 17, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Marissa Brianna Coffers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1184962706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 OAK AVE",
            "address_2": "SUITE 210",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871078",
            "telephone_number": "952-223-2506",
            "fax_number": "952-443-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 OAK AVE",
            "address_2": "SUITE 210",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871078",
            "telephone_number": "952-223-2506",
            "fax_number": "952-443-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARVICH",
        "first_name": "MARISSA",
        "middle_name": "BRIANNA",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-17",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ6115",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "COFFERS",
            "middle_name": "BRIANNA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Marie Froehle
• Janella F Fuchs, CFNP
• Taylor Gallagher
• Brittany Gardner, OTR/L
• Avery Garski
• Janice Bello Gerber
• Samantha Gerring
• Lindsay Marie Getten, LAT
• Connie J Gibson, MSSW LICSW
• Pam Gillund, OTR/L

• Speech-Language Pathologist in Waconia, MN
• Providers in Waconia, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.