Healthcare Provider Details

I. General information

NPI: 1033599857
Provider Name (Legal Business Name): MARIANNE MADZIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2015
Last Update Date: 06/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 SUNSET BLVD
STEUBENVILLE OH
43952-1349
US

IV. Provider business mailing address

2023 SUNSET BLVD
STEUBENVILLE OH
43952-1349
US

V. Phone/Fax

Practice location:
  • Phone: 740-283-3347
  • Fax:
Mailing address:
  • Phone: 740-283-3347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.4017
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP-0245
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: