Provider Demographics
NPI:1215296330
Name:MARSHALL WALKER, GAIL MAUREEN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:MAUREEN
Last Name:MARSHALL WALKER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:9 GLENWOOD TOWNHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:ROUND TOP
Mailing Address - State:NY
Mailing Address - Zip Code:12473-5514
Mailing Address - Country:US
Mailing Address - Phone:518-622-0890
Mailing Address - Fax:
Practice Address - Street 1:71 PROSPECT AVE
Practice Address - Street 2:REHAB DEPARTMENT
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2907
Practice Address - Country:US
Practice Address - Phone:518-828-8341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015193-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist