Provider Demographics
NPI:1871949982
Name:LARGENT, MARIA JAROSCH (MS, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:JAROSCH
Last Name:LARGENT
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:MARIA
Other - Last Name:LARGENT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-A
Mailing Address - Street 1:4985 COUNTY ROAD 116
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-8938
Mailing Address - Country:US
Mailing Address - Phone:352-399-6680
Mailing Address - Fax:
Practice Address - Street 1:4985 COUNTY ROAD 116
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-8938
Practice Address - Country:US
Practice Address - Phone:352-399-6680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2017231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist