Provider Demographics
NPI:1265690721
Name:MARBLE, LAUREN P (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:P
Last Name:MARBLE
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 1:280D ROUTE 130
Mailing Address - Street 2:SUITE 7
Mailing Address - City:FORESTDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02644-1140
Mailing Address - Country:US
Mailing Address - Phone:508-833-1060
Mailing Address - Fax:508-833-2216
Practice Address - Street 1:280D ROUTE 130
Practice Address - Street 2:SUITE 7
Practice Address - City:FORESTDALE
Practice Address - State:MA
Practice Address - Zip Code:02644-1140
Practice Address - Country:US
Practice Address - Phone:508-833-1060
Practice Address - Fax:508-833-2216
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6499235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist