Provider Demographics
NPI:1003011743
Name:FRAKER, MARTA KAY (MS, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:KAY
Last Name:FRAKER
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65706-0085
Mailing Address - Country:US
Mailing Address - Phone:417-425-9732
Mailing Address - Fax:417-889-7077
Practice Address - Street 1:3250 E BATTLEFIELD ST STE N
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4081
Practice Address - Country:US
Practice Address - Phone:417-889-7500
Practice Address - Fax:417-889-7077
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000152517231H00000X
MO001277237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist