MEDICARE: MARLA DESJARLAIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SZ5984	FL

General Provider Information

NPI Number	:	1972933448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLA DESJARLAIS

Provider Business Mailing Address
First Line	:	304 W GIDDENS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 W GIDDENS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-1935
Country	:	US
Telephone Number	:	813-714-9883
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2013
Last Update Date	:	12/04/2025

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Directions to “ MARLA DESJARLAIS ” Practice Location

Language	Start Address	Practice Location

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