Marissa Rae Piasecki, RBT
Individual provider Active NPI Behavior Technician · Fargo, ND
NPI 1750115630 · NPPES record last updated Aug 31, 2024
Key facts
- NPI
- 1750115630
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-24-355102 (WI)
- Practice address
- 4215 31St Ave S Ste a
Fargo, ND 58104-7743 - Phone
- (701) 478-0221
- NPI assigned
- Aug 31, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-355102 | WI | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Intervention Specialists, LLC | Current |
Accepting new patients |
Locations
4215 31st Ave S
Ste A
Fargo, ND 58104
Phone (701) 478-0221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-355102 | WI | Yes |
Addresses
Primary practice location
4215 31St Ave S Ste a
Fargo, ND 58104-7743
Mailing address
602 17TH St
Mosinee, WI 54455-1031
Phone (715) 551-4410
Other providers in Fargo, ND
- Jelisa Phillippi
- Brenda R Phillips
- Eden Phillips
- Sandra L Phillips
- Phyllis Magelky LTD
- Bruce E Piatt
- Payton Piatz
- Dori Anne Picard
- Brittany Gayle Pickard
- Tiffany Amber Pickard
All providers in Fargo, ND · Behavior Technician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.