Provider Demographics
NPI:1801164744
Name:SIMPSON-SEARS, MARION JUNE (MA CCC LSP)
Entity type:Individual
Prefix:MRS
First Name:MARION
Middle Name:JUNE
Last Name:SIMPSON-SEARS
Suffix:
Gender:F
Credentials:MA CCC LSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-5815
Mailing Address - Country:US
Mailing Address - Phone:516-635-0216
Mailing Address - Fax:
Practice Address - Street 1:785 CANDLEWOOD ROAD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-972-1560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004779-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist