Individual provider · Type 1 NPI

Marrisa Modell

Student in an Organized Health Care Education/Training Program · Canton, MI

NPI number 1942016506 Active

Practice location

43825 Michigan Ave
Canton, MI 48188-2551

Call (734) 397-3088 Map

Fax (734) 397-0078

Mailing address

10958 Oak Ln Apt 6216
Van Buren Township, MI 48111-4377

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1942016506

Marrisa Modell's National Provider Identifier is 1942016506, issued on Dec 9, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Canton, MI. The record was last updated on Dec 9, 2024.