Provider Demographics
NPI:1194001552
Name:O'TOOLE, MARILYN S (M A, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:S
Last Name:O'TOOLE
Suffix:
Gender:F
Credentials:M A, CCC-SLP
Other - Prefix:MS
Other - First Name:MARILYN
Other - Middle Name:L
Other - Last Name:STRUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M A, CCC-SLP
Mailing Address - Street 1:535 PARKSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2811
Mailing Address - Country:US
Mailing Address - Phone:216-346-5920
Mailing Address - Fax:
Practice Address - Street 1:535 PARKSIDE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-2811
Practice Address - Country:US
Practice Address - Phone:216-346-5920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP3840235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist