Provider Demographics
NPI:1972335974
Name:MARVIN, MORGAN MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:MARIE
Last Name:MARVIN
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 1:11142 STATE ROUTE 139
Mailing Address - Street 2:
Mailing Address - City:MINFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45653-8718
Mailing Address - Country:US
Mailing Address - Phone:740-222-9212
Mailing Address - Fax:
Practice Address - Street 1:120 AMERICAN BLVD
Practice Address - Street 2:
Practice Address - City:PIKETON
Practice Address - State:OH
Practice Address - Zip Code:45661-7500
Practice Address - Country:US
Practice Address - Phone:740-289-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-17
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.14416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist