Provider Demographics
NPI:1437599784
Name:POLLOCK, MARION COOPER (MS CCC)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:COOPER
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 LOCKSLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2450
Mailing Address - Country:US
Mailing Address - Phone:617-244-7289
Mailing Address - Fax:
Practice Address - Street 1:32 LOCKSLEY RD
Practice Address - Street 2:
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-2450
Practice Address - Country:US
Practice Address - Phone:617-244-7289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1130235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist