Provider Demographics
NPI:1740480953
Name:HUCK, MARILYN JOYCE (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:JOYCE
Last Name:HUCK
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:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67029-0164
Mailing Address - Country:US
Mailing Address - Phone:620-582-2464
Mailing Address - Fax:
Practice Address - Street 1:250 W DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-3110
Practice Address - Country:US
Practice Address - Phone:316-945-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS226235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist