Marissa Vidal

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

02327L Issued in MD

Practice address

15850 Crabbs Branch Way # 150
Rockville, MD 20855-2622

Phone

(301) 869-7505

NPI assigned

Jul 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1891368924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9916 SHELBURNE TER APT 202",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15850 CRABBS BRANCH WAY # 150",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208552622",
            "telephone_number": "301-869-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "02327L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.pdcandme.com/",
            "affiliation": "Y",
            "affiliationName": "The Pediatric Development Center, llc",
            "address_1": "15850 Crabbs Branch Way # 150",
            "city": "Rockville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208552622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Anne Vetter, DPT
• Tiera Vialet
• Vicente Figueroa MD
• Devon Vickery
• Eriny Victor, PHARM D.
• Jennifer Douglas Vidas, PH.D.
• Jaskiran Kaur Vidwan, D.O.
• Jackson Vieth
• Raul Vigil
• Vigilant Care Anesthesia LLC

• Speech-Language Pathologist in Rockville, MD
• Providers in Rockville, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.