Provider Demographics
NPI:1851471973
Name:LAWRENCE, MARLO BAILEY (AUD)
Entity Type:Individual
Prefix:
First Name:MARLO
Middle Name:BAILEY
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MARLO
Other - Middle Name:M
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:9723 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7207
Mailing Address - Country:US
Mailing Address - Phone:513-675-8595
Mailing Address - Fax:513-793-9576
Practice Address - Street 1:9723 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7207
Practice Address - Country:US
Practice Address - Phone:513-675-8595
Practice Address - Fax:513-793-9576
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01360237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter