Provider Demographics
NPI:1487992269
Name:SPINALE, MARILYN R (MS, CCC-A)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:R
Last Name:SPINALE
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MASSACHUSETTS EYE & EAR
Mailing Address - Street 2:500 CONGRESS ST SUITE 2B
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169
Mailing Address - Country:US
Mailing Address - Phone:617-774-1717
Mailing Address - Fax:617-479-4770
Practice Address - Street 1:MASSACHUSETTS EYE & EAR
Practice Address - Street 2:500 CONGRESS ST SUITE 2B
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169
Practice Address - Country:US
Practice Address - Phone:617-774-1717
Practice Address - Fax:617-479-4770
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA315231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist