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Individual

MARIANA MARITATO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S. CCC-SLP

Contact information

Practice address
718 MAIN ST # 1A, CALDWELL, ID 83605-3744
(208) 649-5036
Mailing address
213 ABRAHAM WAY APT 101, CALDWELL, ID 83607-5280
(208) 649-5036

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2225
ID
235Z00000X
Speech-Language Pathologist
SLP4459
AZ

Other

Enumeration date
05/06/2007
Last updated
07/01/2013
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