Provider Demographics
NPI:1740626449
Name:MARCHESE, MARIA (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:MARCHESE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 CONYERS CT
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-5234
Mailing Address - Country:US
Mailing Address - Phone:386-490-5535
Mailing Address - Fax:
Practice Address - Street 1:1101 PARC HILL BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8029
Practice Address - Country:US
Practice Address - Phone:386-247-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7716235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist