| Doctor Name: | TRICIA MARAVILLA |
| NPI Number: | 1558775783 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., CCC-SLP |
| License Number: | 15849 |
| Business Practice Address: | 18700 Beach Blvd Ste 120 Huntington Beach, CA - 926482089 |
| Business Phone Number: | 7149626760 |
| Business Fax Number: | |
| Mailing Address: | 7911 E Rosina St, LONG BEACH |
| State: | CA |
| Postal Code: | 908084463 |
| Phone Number: | 5628821831 |
| Fax Number: | |
| NPI Enumeration Date: | 06/16/2014 |
| NPI Last Update Date: | 06/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 15849 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |