Provider Demographics
NPI:1326175654
Name:AKESON, MARCIA (SLP)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:AKESON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 S SCOTT BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-2909
Mailing Address - Country:US
Mailing Address - Phone:319-354-2429
Mailing Address - Fax:319-354-6100
Practice Address - Street 1:1130 S SCOTT BLVD
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-2908
Practice Address - Country:US
Practice Address - Phone:319-354-2429
Practice Address - Fax:319-354-6100
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665463Medicaid
IA166546Medicare ID - Type Unspecified