Marissa D'Ambrosio

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL017204 Issued in PA

Practice address

400 Old Forge LN Ste 407
Kennett Square, PA 19348-1918

Phone

(484) 367-7131

NPI assigned

Dec 5, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1295502805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MORGAN RD",
            "city": "ASTON",
            "state": "PA",
            "postal_code": "190142528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OLD FORGE LN STE 407",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481918",
            "telephone_number": "484-367-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMBROSIO",
        "first_name": "MARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL017204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Creadon, MS CCC-SLP
• Jennifer Anne Crossan, CRNP
• Cure Ambulance, Inc.
• Beth Curtis
• Nicole Cusa, M.P.T.
• Nicholas Angelo D'Amico
• Nicholas D'Orazio, M.D.
• Marie Daddario
• Cheryl Johian Dalrymple, PTA
• Eliot Deforest Dalton, MA, LPC

• Speech-Language Pathologist in Kennett Square, PA
• Providers in Kennett Square, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.