Provider Demographics
NPI:1548510308
Name:MARANIA, MARIA ELENA (RPT)
Entity type:Individual
Prefix:
First Name:MARIA ELENA
Middle Name:
Last Name:MARANIA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 NORTH 595 EAST
Mailing Address - Street 2:
Mailing Address - City:DEMOTTE
Mailing Address - State:IN
Mailing Address - Zip Code:46310-8968
Mailing Address - Country:US
Mailing Address - Phone:630-487-9728
Mailing Address - Fax:
Practice Address - Street 1:10352 N 600 E
Practice Address - Street 2:
Practice Address - City:DEMOTTE
Practice Address - State:IN
Practice Address - Zip Code:46310-8959
Practice Address - Country:US
Practice Address - Phone:219-345-5211
Practice Address - Fax:219-345-4949
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010896A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist