Provider Demographics
NPI:1154179141
Name:MARIANNE CROISANT
Entity type:Organization
Organization Name:MARIANNE CROISANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROISANT
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP/L
Authorized Official - Phone:309-306-1664
Mailing Address - Street 1:415 N DUNLAP AVE
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-1040
Mailing Address - Country:US
Mailing Address - Phone:309-306-1664
Mailing Address - Fax:
Practice Address - Street 1:415 N DUNLAP AVE
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-1040
Practice Address - Country:US
Practice Address - Phone:309-306-1664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty