Provider Demographics
NPI:1013618537
Name:RENNIE, MARIANNA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:RENNIE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MARIANNA
Other - Middle Name:
Other - Last Name:FLOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:112 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1838
Mailing Address - Country:US
Mailing Address - Phone:732-439-7426
Mailing Address - Fax:
Practice Address - Street 1:1 SHEPHERDS WAY
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-4201
Practice Address - Country:US
Practice Address - Phone:215-956-2270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL015998235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist