Provider Demographics
NPI:1801055702
Name:GARANZUAY, MARIE F (SLP)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:F
Last Name:GARANZUAY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12708 RIATA VISTA CIR STE A-106
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-7174
Mailing Address - Country:US
Mailing Address - Phone:512-795-2422
Mailing Address - Fax:512-852-4485
Practice Address - Street 1:12708 RIATA VISTA CIR STE A-106
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-7174
Practice Address - Country:US
Practice Address - Phone:512-795-2422
Practice Address - Fax:512-852-4485
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104129235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist