Provider Demographics
NPI:1508258757
Name:MARLOW, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MARLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 WEST HUNTER
Mailing Address - Street 2:
Mailing Address - City:VIAN
Mailing Address - State:OK
Mailing Address - Zip Code:74962
Mailing Address - Country:US
Mailing Address - Phone:918-773-5798
Mailing Address - Fax:918-773-8772
Practice Address - Street 1:203 W HUNTER
Practice Address - Street 2:
Practice Address - City:VIAN
Practice Address - State:OK
Practice Address - Zip Code:74962-1048
Practice Address - Country:US
Practice Address - Phone:918-773-5798
Practice Address - Fax:918-773-8772
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK145029235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist