Provider Demographics
NPI:1497097117
Name:MARATTA, EMILY ANN
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANN
Last Name:MARATTA
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 1:3728 CRESWICK CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-7394
Mailing Address - Country:US
Mailing Address - Phone:407-440-4985
Mailing Address - Fax:
Practice Address - Street 1:14428 TURNING LEAF DRIVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828
Practice Address - Country:US
Practice Address - Phone:321-961-3489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ12045235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA12045OtherPROFESSIONAL SPEECH LANGUAGE PATHOLOGY LICENSE