Provider Demographics
NPI:1164551461
Name:LEPP, MARILYN (SLP)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:LEPP
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 WHITTIER ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-1924
Mailing Address - Country:US
Mailing Address - Phone:251-895-5660
Mailing Address - Fax:
Practice Address - Street 1:998 WHITTIER ST
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1924
Practice Address - Country:US
Practice Address - Phone:251-895-5660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2806235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00936XMedicare ID - Type UnspecifiedPART B GROUP NUMBER
TX676626Medicare Oscar/Certification
TX676559Medicare Oscar/Certification
TX676555Medicare Oscar/Certification
TX676564Medicare Oscar/Certification
TX676600Medicare Oscar/Certification
TX676554Medicare Oscar/Certification