Provider Demographics
NPI:1689086340
Name:WARRINGTON, MARIAH
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:WARRINGTON
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 1:37267 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SARDIS
Mailing Address - State:OH
Mailing Address - Zip Code:43946-9770
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:37267 5TH AVE
Practice Address - Street 2:
Practice Address - City:SARDIS
Practice Address - State:OH
Practice Address - Zip Code:43946-9770
Practice Address - Country:US
Practice Address - Phone:740-213-3080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.10502235Z00000X
WVSLP-1448235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist