Provider Demographics
NPI:1912047424
Name:MARQUIS, LINDA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MARQUIS
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 1:97 SHELTON RD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2844
Mailing Address - Country:US
Mailing Address - Phone:781-598-0977
Mailing Address - Fax:
Practice Address - Street 1:213 ESSEX STREET
Practice Address - Street 2:S 2
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907
Practice Address - Country:US
Practice Address - Phone:781-248-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251436235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA251436OtherSPEECH-LANGUAGE PATHOLOGI