Provider Demographics
NPI:1578780318
Name:ENOCK, MARILYN (AUD, MS, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:
Last Name:ENOCK
Suffix:
Gender:F
Credentials:AUD, MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6315 FORBES AVE
Mailing Address - Street 2:SUITE 108B
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1745
Mailing Address - Country:US
Mailing Address - Phone:412-521-5890
Mailing Address - Fax:412-521-2872
Practice Address - Street 1:6315 FORBES AVE
Practice Address - Street 2:SUITE 108B
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1745
Practice Address - Country:US
Practice Address - Phone:412-521-5890
Practice Address - Fax:412-521-2872
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT001169L231H00000X
WVA-0220231H00000X
OHA 01544231H00000X
NY002071231H00000X
PAF03122237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01922665Medicaid