Provider Demographics
NPI:1578016119
Name:MARRANO, CONSTANCE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:MARRANO
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 1:210 W DIVISION ST
Mailing Address - Street 2:APARTMENT #35
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-1566
Mailing Address - Country:US
Mailing Address - Phone:914-202-5537
Mailing Address - Fax:
Practice Address - Street 1:210 W DIVISION ST
Practice Address - Street 2:APARTMENT #35
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-1566
Practice Address - Country:US
Practice Address - Phone:914-202-5537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025956251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)