Provider Demographics
NPI:1902672520
Name:DE MARIA, KERRIANN (BS, L-SLPA)
Entity Type:Individual
Prefix:
First Name:KERRIANN
Middle Name:
Last Name:DE MARIA
Suffix:
Gender:F
Credentials:BS, L-SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9703 AVELLINO AVE UNIT 1424
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8817
Mailing Address - Country:US
Mailing Address - Phone:561-818-8117
Mailing Address - Fax:
Practice Address - Street 1:301 S WEST CROWN POINT RD STE 150
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2917
Practice Address - Country:US
Practice Address - Phone:407-905-8908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI59042355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant