Provider Demographics
NPI:1710409966
Name:VARNHAGEN, MARY (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:VARNHAGEN
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 1:220 CARROLL WAY
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-1336
Mailing Address - Country:US
Mailing Address - Phone:630-885-0138
Mailing Address - Fax:
Practice Address - Street 1:220 CARROLL WAY
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-1336
Practice Address - Country:US
Practice Address - Phone:630-885-0138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist