Provider Demographics
NPI:1326251372
Name:TAPAJNA, MARILYN K (MATCCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:K
Last Name:TAPAJNA
Suffix:
Gender:F
Credentials:MATCCC-SLP
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:KENT
Other - Last Name:TAPAJNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MATCCC-SLP
Mailing Address - Street 1:2239 CARROLL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-1643
Mailing Address - Country:US
Mailing Address - Phone:708-799-8362
Mailing Address - Fax:708-799-8427
Practice Address - Street 1:2239 CARROLL PARKWAY
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-1643
Practice Address - Country:US
Practice Address - Phone:708-799-8362
Practice Address - Fax:708-799-8427
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146003132235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist