Provider Demographics
NPI:1982839502
Name:MARSHALL, TARA S (SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:S
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PARK ST
Mailing Address - Street 2:ALBERTSON HALL 131
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-4009
Mailing Address - Country:US
Mailing Address - Phone:785-628-5366
Mailing Address - Fax:
Practice Address - Street 1:600 PARK ST
Practice Address - Street 2:ALBERTSON HALL 131
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4009
Practice Address - Country:US
Practice Address - Phone:785-628-5366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2249235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist