Provider Demographics
NPI:1891030987
Name:LOERTSCHER, MARIANNE RIRIE (MS/CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:RIRIE
Last Name:LOERTSCHER
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 1:5391 S 550 E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TERRACE
Mailing Address - State:UT
Mailing Address - Zip Code:84405-4739
Mailing Address - Country:US
Mailing Address - Phone:801-915-3979
Mailing Address - Fax:
Practice Address - Street 1:5391 S 550 E
Practice Address - Street 2:
Practice Address - City:WASHINGTON TERRACE
Practice Address - State:UT
Practice Address - Zip Code:84405-4739
Practice Address - Country:US
Practice Address - Phone:801-915-3979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT112732-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist