Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marissa Peterson, MA/CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1669633590

Marissa Peterson, MA/CCC-SLP is a Speech-Language Pathologist in Idaho Falls, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2008

Practice location Address checks out

545 Lincoln Dr
Idaho Falls, ID 83401-4118
Phone: (208) 757-8553
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SLP-1685 (ID)

Record details

NPI number1669633590
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA/CCC-SLP
Sole proprietorYes
NPI enumeratedJune 23, 2008
Last updated in NPPESJuly 12, 2009

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