Provider Demographics
NPI:1457905754
Name:MCGUIRE, MARIROSE REODICA (SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:MARIROSE
Middle Name:REODICA
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16-590 KEAAU PAHOA RD
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-8105
Mailing Address - Country:US
Mailing Address - Phone:808-982-4252
Mailing Address - Fax:808-982-4292
Practice Address - Street 1:16-590 KEAAU PAHOA RD
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-8105
Practice Address - Country:US
Practice Address - Phone:808-982-4252
Practice Address - Fax:808-982-4292
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14193685235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist