Provider Demographics
NPI:1013114446
Name:PLAYER, MARIAN GRAY (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIAN
Middle Name:GRAY
Last Name:PLAYER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8113 GLENBRITTLE WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4736
Mailing Address - Country:US
Mailing Address - Phone:919-848-0492
Mailing Address - Fax:919-848-0492
Practice Address - Street 1:8113 GLENBRITTLE WAY
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4736
Practice Address - Country:US
Practice Address - Phone:919-848-0492
Practice Address - Fax:919-848-0492
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1445235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7411716Medicaid