Provider Demographics
NPI:1538941216
Name:MARANT, MARIE C (MS, CCC-SLP, CMT)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:C
Last Name:MARANT
Suffix:
Gender:F
Credentials:MS, CCC-SLP, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12613 LANCEY CT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3357
Mailing Address - Country:US
Mailing Address - Phone:804-399-8515
Mailing Address - Fax:
Practice Address - Street 1:411 BRANCHWAY RD STE 108
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3034
Practice Address - Country:US
Practice Address - Phone:804-399-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001463235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist