Provider Demographics
NPI:1417223553
Name:STERNBERG, MARSHA L (MSCCC-SP)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:L
Last Name:STERNBERG
Suffix:
Gender:F
Credentials:MSCCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1579 S FOLSOMVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47601-9465
Mailing Address - Country:US
Mailing Address - Phone:812-897-4840
Mailing Address - Fax:812-897-0123
Practice Address - Street 1:1579 S FOLSOMVILLE RD
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47601-9465
Practice Address - Country:US
Practice Address - Phone:812-897-4840
Practice Address - Fax:812-897-0123
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22001339A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist