Provider Demographics
NPI:1386179018
Name:MARRERO, NADINA
Entity Type:Individual
Prefix:
First Name:NADINA
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 VIA AVENTURA
Mailing Address - Street 2:APT. 5208
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6184
Mailing Address - Country:US
Mailing Address - Phone:787-529-9707
Mailing Address - Fax:
Practice Address - Street 1:350 VIA AVENTURA
Practice Address - Street 2:APT. 5208
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-6184
Practice Address - Country:US
Practice Address - Phone:787-529-9707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4025235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist