Provider Demographics
NPI:1003247206
Name:MARBLE, MEGAN (SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MARBLE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:990 MARSH AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-2530
Mailing Address - Country:US
Mailing Address - Phone:530-559-4085
Mailing Address - Fax:
Practice Address - Street 1:4741 CAUGHLIN PKWY STE 2
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-0983
Practice Address - Country:US
Practice Address - Phone:775-376-1934
Practice Address - Fax:775-376-1936
Is Sole Proprietor?:No
Enumeration Date:2013-12-13
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60423769235Z00000X
NVSP-2083235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist