Individual provider Active NPI

Marissa Brezner, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Wilmington, NC
National Provider Identifier
1568859353
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11331 Issued in NC
Practice address
5919 Oleander Dr
Suite 119
Wilmington, NC 28403-4780
Phone
(910) 395-2995
NPI assigned
Apr 20, 2015
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 11331 NC Primary

Addresses

Primary practice location

5919 Oleander Dr
Suite 119
Wilmington, NC 28403-4780

Mailing address

417 Rock St
Fall River, MA 02720-3344
Phone (508) 675-8420

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
11331NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1568859353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 ROCK ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203344",
            "telephone_number": "508-675-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5919 OLEANDER DR",
            "address_2": "SUITE 119",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034780",
            "telephone_number": "910-395-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREZNER",
        "first_name": "MARISSA",
        "name_prefix": "Miss",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.