Provider Demographics
NPI:1972814085
Name:LITTMAN, MARILYN FREDA
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:FREDA
Last Name:LITTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 TIMBER HILL DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-7949
Mailing Address - Country:US
Mailing Address - Phone:609-235-9934
Mailing Address - Fax:609-235-9934
Practice Address - Street 1:127 TIMBER HILL DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-7949
Practice Address - Country:US
Practice Address - Phone:609-235-9934
Practice Address - Fax:609-235-9934
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011219-1235Z00000X
NJ41YS00457900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist