Marissa Nunnery, M.A. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · San Antonio, TX

NPI 1346885993 · NPPES record last updated Jan 26, 2023

Key facts

NPI
1346885993
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
117977 (TX)
Practice address
14163 Blind Bandit CRK
San Antonio, TX 78254-4692
Phone
(915) 873-1221
NPI assigned
Nov 7, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
117977TXMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 117977 TX Yes

Addresses

Primary practice location

14163 Blind Bandit CRK
San Antonio, TX 78254-4692

Mailing address

14163 Blind Bandit CRK
San Antonio, TX 78254-4692
Phone (915) 873-1221

Other providers in San Antonio, TX

All providers in San Antonio, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.