Doctor Name: | KELLY J MARX |
NPI Number: | 1609000587 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 22001948A |
Business Practice Address: | 4661 N 1250 E Greentown, IN - 469369634 |
Business Phone Number: | 3212920640 |
Business Fax Number: | |
Mailing Address: | 4661 N 1250 E, GREENTOWN |
State: | IN |
Postal Code: | 469369634 |
Phone Number: | 3212920640 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2009 |
NPI Last Update Date: | 05/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22001948A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |