Provider Demographics
NPI:1538983804
Name:ANAYA, MARISSA
Entity type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:
Last Name:ANAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MARISSA
Other - Middle Name:ANAYA
Other - Last Name:GERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:617 N SCOTTSDALE RD STE D
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-4207
Mailing Address - Country:US
Mailing Address - Phone:480-990-3720
Mailing Address - Fax:480-990-8085
Practice Address - Street 1:617 N SCOTTSDALE RD STE D
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-4207
Practice Address - Country:US
Practice Address - Phone:480-990-3720
Practice Address - Fax:480-990-8085
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty