Provider Demographics
NPI:1558516484
Name:NEIL, MARILYN S (MA ED, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:S
Last Name:NEIL
Suffix:
Gender:F
Credentials:MA ED, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5233 ASHTON PINES LN
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-7488
Mailing Address - Country:US
Mailing Address - Phone:941-921-1448
Mailing Address - Fax:941-921-1488
Practice Address - Street 1:5233 ASHTON PINES LN
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-7488
Practice Address - Country:US
Practice Address - Phone:941-921-1448
Practice Address - Fax:941-921-1488
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA1140235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist