Provider Demographics
NPI:1518368695
Name:MARBLE, JENNYKATE (MLIS, MED)
Entity Type:Individual
Prefix:
First Name:JENNYKATE
Middle Name:
Last Name:MARBLE
Suffix:
Gender:F
Credentials:MLIS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9719
Mailing Address - Country:US
Mailing Address - Phone:646-785-6947
Mailing Address - Fax:
Practice Address - Street 1:30 OLD LYMAN ROAD
Practice Address - Street 2:
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075
Practice Address - Country:US
Practice Address - Phone:413-533-7140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant