Provider Demographics
NPI:1922395060
Name:SCHOENBERG, MARLENE IRIS (EDMCCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:IRIS
Last Name:SCHOENBERG
Suffix:
Gender:F
Credentials:EDMCCC/SLP
Other - Prefix:MRS
Other - First Name:MARLENE
Other - Middle Name:COHEN
Other - Last Name:SCHOENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3915 GOLDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4249
Mailing Address - Country:US
Mailing Address - Phone:763-520-0679
Mailing Address - Fax:763-520-0355
Practice Address - Street 1:3915 GOLDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4249
Practice Address - Country:US
Practice Address - Phone:763-520-0679
Practice Address - Fax:763-520-0355
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5468235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist