Healthcare Provider Details

I. General information

NPI: 1871703579
Provider Name (Legal Business Name): MARISOL BERRIOS-BAEZ MS, C.C.C. SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 SPRUCE AVE
WILMINGTON DE
19805-2148
US

IV. Provider business mailing address

293 MINGO WAY
TOWNSEND DE
19734-9439
US

V. Phone/Fax

Practice location:
  • Phone: 302-552-3700
  • Fax:
Mailing address:
  • Phone: 302-373-4346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberO1-0001444
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number543
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: