Provider Demographics
NPI:1124216114
Name:RACOP, MARSHA C
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:C
Last Name:RACOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 ZUCK RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4936
Mailing Address - Country:US
Mailing Address - Phone:814-836-3305
Mailing Address - Fax:814-456-4873
Practice Address - Street 1:4850 ZUCK RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4936
Practice Address - Country:US
Practice Address - Phone:814-836-3305
Practice Address - Fax:814-836-3370
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008973235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist