Provider Demographics
NPI:1235198102
Name:CHAVES, MARCI D (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARCI
Middle Name:D
Last Name:CHAVES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 WELLINGTON GREEN DR
Mailing Address - Street 2:APT 5-201
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9315
Mailing Address - Country:US
Mailing Address - Phone:561-790-3709
Mailing Address - Fax:
Practice Address - Street 1:2325 WELLINGTON GREEN DR
Practice Address - Street 2:APT 5-201
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-9315
Practice Address - Country:US
Practice Address - Phone:561-790-3709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist