Doctor Name: | MRS. MARILYN GOERTEL-BREEN |
NPI Number: | 1063875805 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 827 |
Business Practice Address: | 12251 Highway 41 N Suite A Evansville, IN - 477257014 |
Business Phone Number: | 8128681224 |
Business Fax Number: | 8667159733 |
Mailing Address: | 14440 N 51st Ave W, MINGO |
State: | IA |
Postal Code: | 501688544 |
Phone Number: | 5155778847 |
Fax Number: | |
NPI Enumeration Date: | 03/30/2016 |
NPI Last Update Date: | 03/30/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 827 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |