Provider Demographics
NPI:1629109921
Name:MARZOLF, CARI ANN (MA CCCA)
Entity Type:Individual
Prefix:MS
First Name:CARI
Middle Name:ANN
Last Name:MARZOLF
Suffix:
Gender:F
Credentials:MA CCCA
Other - Prefix:MISS
Other - First Name:CARI
Other - Middle Name:ANN
Other - Last Name:KURATKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCCA
Mailing Address - Street 1:PO BOX 452
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:MI
Mailing Address - Zip Code:49406
Mailing Address - Country:US
Mailing Address - Phone:269-857-8439
Mailing Address - Fax:
Practice Address - Street 1:926 S WASHINGTON
Practice Address - Street 2:BLDG D SUITE 230
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423
Practice Address - Country:US
Practice Address - Phone:616-594-2006
Practice Address - Fax:616-396-3548
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000182231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist