Provider Demographics
NPI:1902585458
Name:MARENIN, BRIGITTE IVONNE (CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRIGITTE
Middle Name:IVONNE
Last Name:MARENIN
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 WINTER ST SE BLDG B
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3934
Mailing Address - Country:US
Mailing Address - Phone:626-590-7013
Mailing Address - Fax:
Practice Address - Street 1:665 WINTER ST SE BLDG B
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3934
Practice Address - Country:US
Practice Address - Phone:503-814-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17869235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist