Provider Demographics
NPI:1508007246
Name:MARARIKE, SHEPHERD TAONEZVI (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:SHEPHERD
Middle Name:TAONEZVI
Last Name:MARARIKE
Suffix:
Gender:M
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 DUNANDERRY WAY
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:MA
Mailing Address - Zip Code:01612-1528
Mailing Address - Country:US
Mailing Address - Phone:508-795-7053
Mailing Address - Fax:
Practice Address - Street 1:12 DUNANDERRY WAY
Practice Address - Street 2:
Practice Address - City:PAXTON
Practice Address - State:MA
Practice Address - Zip Code:01612-1528
Practice Address - Country:US
Practice Address - Phone:508-795-7053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4963235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist