Provider Demographics
NPI:1841936473
Name:MARIONEAUX, ERIN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:MARIONEAUX
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 HEISLER ST
Mailing Address - Street 2:
Mailing Address - City:PORT NECHES
Mailing Address - State:TX
Mailing Address - Zip Code:77651-2213
Mailing Address - Country:US
Mailing Address - Phone:409-344-1635
Mailing Address - Fax:
Practice Address - Street 1:1522 HEISLER ST
Practice Address - Street 2:
Practice Address - City:PORT NECHES
Practice Address - State:TX
Practice Address - Zip Code:77651-2213
Practice Address - Country:US
Practice Address - Phone:409-344-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110343235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist