Provider Demographics
NPI:1568666279
Name:BUTLER, MARJORIE ELIZABETH (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:ELIZABETH
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 MILWAUKEE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4334
Mailing Address - Country:US
Mailing Address - Phone:303-570-6604
Mailing Address - Fax:
Practice Address - Street 1:542 MILWAUKEE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4334
Practice Address - Country:US
Practice Address - Phone:303-570-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
09101313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist