Provider Demographics
NPI:1033403654
Name:MARIN, EVA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:
Last Name:MARIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 CORPUS CHRISTI ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5208
Mailing Address - Country:US
Mailing Address - Phone:956-723-5700
Mailing Address - Fax:956-723-5706
Practice Address - Street 1:1020 CORPUS CHRISTI ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-5208
Practice Address - Country:US
Practice Address - Phone:956-723-5700
Practice Address - Fax:956-723-5706
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106140235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist