Provider Demographics
NPI:1518392018
Name:SCHOENBART, MARISA ALEX (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:ALEX
Last Name:SCHOENBART
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 1:18 CLOVEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1304
Mailing Address - Country:US
Mailing Address - Phone:914-557-4085
Mailing Address - Fax:
Practice Address - Street 1:18 CLOVEBROOK RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1304
Practice Address - Country:US
Practice Address - Phone:914-557-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024200-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist