Provider Demographics
NPI:1033458591
Name:PATTERSON, MARIANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:SERVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:51 BEACON HILL RD APT C
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-1256
Mailing Address - Country:US
Mailing Address - Phone:201-572-3860
Mailing Address - Fax:
Practice Address - Street 1:51 BEACON HILL RD APT C
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1256
Practice Address - Country:US
Practice Address - Phone:201-572-3860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00400400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist