Provider Demographics
NPI:1205064664
Name:MARZANO, DAWN MARIE
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE
Last Name:MARZANO
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 1:5790 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-3984
Mailing Address - Country:US
Mailing Address - Phone:330-797-8800
Mailing Address - Fax:330-797-8808
Practice Address - Street 1:5204 MAHONING AVE
Practice Address - Street 2:105
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-1808
Practice Address - Country:US
Practice Address - Phone:330-797-8800
Practice Address - Fax:330-797-8808
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 5080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist