Provider Demographics
NPI:1104034974
Name:CAGE, MARLO T (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARLO
Middle Name:T
Last Name:CAGE
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 HOME POINT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-5568
Mailing Address - Country:US
Mailing Address - Phone:559-240-4772
Mailing Address - Fax:
Practice Address - Street 1:3308 HOME POINT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091
Practice Address - Country:US
Practice Address - Phone:559-240-4772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103908235Z00000X
OHSP.12890235Z00000X
NH1853235Z00000X
CASP9634235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist