Provider Demographics
NPI:1861970394
Name:KOLBECK, MARISSA
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:KOLBECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:
Other - Last Name:D'ANDREA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:363 VANADIUM RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1477
Mailing Address - Country:US
Mailing Address - Phone:412-489-0474
Mailing Address - Fax:
Practice Address - Street 1:363 VANADIUM RD STE 300
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1477
Practice Address - Country:US
Practice Address - Phone:412-489-6357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician