Provider Demographics
NPI:1225648264
Name:NEUGEBAUER, MARCIA (CCC, SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:
Last Name:NEUGEBAUER
Suffix:
Gender:F
Credentials:CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19B TRIUMPH CT
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-1147
Mailing Address - Country:US
Mailing Address - Phone:401-499-6227
Mailing Address - Fax:
Practice Address - Street 1:19B TRIUMPH CT
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-1147
Practice Address - Country:US
Practice Address - Phone:401-499-6227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00899400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty