Provider Demographics
NPI:1134726144
Name:DAIGLE, MARISA M
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:M
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7146 BUTTERCUP LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-1406
Mailing Address - Country:US
Mailing Address - Phone:248-462-4966
Mailing Address - Fax:
Practice Address - Street 1:2000 E OAKLEY PARK RD STE 101B
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-1500
Practice Address - Country:US
Practice Address - Phone:248-387-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist