Provider Demographics
NPI:1164238101
Name:CORTINAS, MARISSA (BCBA)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:CORTINAS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 MARGHERITA PL
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-4811
Mailing Address - Country:US
Mailing Address - Phone:848-469-6271
Mailing Address - Fax:
Practice Address - Street 1:100 WALNUT AVE STE 210
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1269
Practice Address - Country:US
Practice Address - Phone:908-731-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst