MARISSA PETERSON MA/CCC-SLP NPI 1669633590

NPI Information

  • NPI: 1669633590
  • Provider Name: MARISSA PETERSON, MA/CCC-SLP
  • Classification: Speech-Language Pathologist - 235Z00000X
  • Entity Type: Individual
  • Address: 545 LINCOLN DR
    IDAHO FALLS, ID
    ZIP 83401
  • Phone: (208) 757-8553

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NPI Details

Marissa Peterson, MA/CCC-SLP is a speech language pathologist in Idaho Falls, ID. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. Marissa Peterson, MA/CCC-SLP NPI is 1669633590. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

545 LINCOLN DR
IDAHO FALLS, ID
ZIP 83401-118
Phone: (208) 757-8553

The enumeration date for this NPI number is 6/23/2008 and was last updated on 7/12/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language PathologistSLP-1685IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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