Provider Demographics
NPI:1689147860
Name:RATH, MARLEE RENEE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARLEE
Middle Name:RENEE
Last Name:RATH
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7600 NORTH 16TH STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020
Mailing Address - Country:US
Mailing Address - Phone:602-368-3282
Mailing Address - Fax:602-314-4175
Practice Address - Street 1:7600 NORTH 16TH STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020
Practice Address - Country:US
Practice Address - Phone:602-368-3282
Practice Address - Fax:602-314-4175
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
AZSLP13256235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician