Provider Demographics
NPI:1548406341
Name:PRUNEDA, MARIANNA M (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARIANNA
Middle Name:M
Last Name:PRUNEDA
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 1:3101 MICHAELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-2894
Mailing Address - Country:US
Mailing Address - Phone:956-226-9376
Mailing Address - Fax:
Practice Address - Street 1:3101 MICHAELWOOD DR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-2894
Practice Address - Country:US
Practice Address - Phone:956-226-9376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100808235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist