Provider Demographics
NPI:1255705372
Name:MARCHETTI, PATRICIA LAURA (MSSLP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LAURA
Last Name:MARCHETTI
Suffix:
Gender:F
Credentials:MSSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HEWITT AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-3906
Mailing Address - Country:US
Mailing Address - Phone:917-757-5145
Mailing Address - Fax:
Practice Address - Street 1:4 HEWITT AVE
Practice Address - Street 2:WHITE PLAINS
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-3906
Practice Address - Country:US
Practice Address - Phone:917-757-5145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013559235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist