Doctor Name: | PAMELA PALMER MARIENTHAL |
NPI Number: | 1548601131 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 104882 |
Business Practice Address: | 2311 S Jackson Ave Joplin, MO - 648041936 |
Business Phone Number: | 4177812311 |
Business Fax Number: | |
Mailing Address: | 4617 S Jackson Ave, JOPLIN |
State: | MO |
Postal Code: | 648044836 |
Phone Number: | 4176224655 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2013 |
NPI Last Update Date: | 07/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 104882 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
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 |