Provider Demographics
NPI:1326442369
Name:DE ROIA, MARIELAINE (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIELAINE
Middle Name:
Last Name:DE ROIA
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9198 DARROW ROAD
Mailing Address - Street 2:WILCOX PRIMARY SCHOOL
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087
Mailing Address - Country:US
Mailing Address - Phone:330-486-2068
Mailing Address - Fax:
Practice Address - Street 1:9198 DARROW RD
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1856
Practice Address - Country:US
Practice Address - Phone:330-486-2068
Practice Address - Fax:330-963-8332
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 2846235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist