Provider Demographics
NPI:1699162917
Name:ENGINGER, MARIANNE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:ENGINGER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 TOWN SQUARE CIR
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-2178
Mailing Address - Country:US
Mailing Address - Phone:859-496-9805
Mailing Address - Fax:
Practice Address - Street 1:300 TOWN SQUARE CIR
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:KY
Practice Address - Zip Code:41076-2178
Practice Address - Country:US
Practice Address - Phone:859-496-9805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3662235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist