Provider Demographics
NPI:1609994870
Name:KLEIN, MARILYN S (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:S
Last Name:KLEIN
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 1:25 TRINITY ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1719
Mailing Address - Country:US
Mailing Address - Phone:978-774-2554
Mailing Address - Fax:
Practice Address - Street 1:25 TRINITY ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1719
Practice Address - Country:US
Practice Address - Phone:978-774-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3739235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist