Provider Demographics
NPI:1114703386
Name:HUYS, MARLISE ANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARLISE
Middle Name:ANNE
Last Name:HUYS
Suffix:
Gender:F
Credentials:MS, 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:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:LOON LAKE
Mailing Address - State:SK
Mailing Address - Zip Code:S0M1L0
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36 PONY TRAIL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE ESTATES
Practice Address - State:SK
Practice Address - Zip Code:S7T1A3
Practice Address - Country:CA
Practice Address - Phone:306-371-6207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ12136776235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist