Provider Demographics
NPI:1588981815
Name:SWEARINGIN, MARILYN KAY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:KAY
Last Name:SWEARINGIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23598 WALNUT HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-3578
Mailing Address - Country:US
Mailing Address - Phone:618-498-5761
Mailing Address - Fax:
Practice Address - Street 1:23598 WALNUT HOLLOW CT
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-3578
Practice Address - Country:US
Practice Address - Phone:618-498-5761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.001111235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146.001111OtherLICENSURE