Provider Demographics
NPI:1316015100
Name:VERA, MARIANELLY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIANELLY
Middle Name:
Last Name:VERA
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 1:51 BROOKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5942
Mailing Address - Country:US
Mailing Address - Phone:302-832-3620
Mailing Address - Fax:
Practice Address - Street 1:101 BARRETT RUN DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-2949
Practice Address - Country:US
Practice Address - Phone:302-454-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist