Provider Demographics
NPI:1124189709
Name:MARSHALL, ANNE K (MED CCC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:K
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MED CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 HAMILL LN
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-3614
Mailing Address - Country:US
Mailing Address - Phone:405-615-9228
Mailing Address - Fax:405-293-9502
Practice Address - Street 1:609 HAMILL LN
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-3614
Practice Address - Country:US
Practice Address - Phone:405-615-9228
Practice Address - Fax:405-293-9502
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist