Provider Demographics
NPI:1982191474
Name:CHRISTIE, MARCIA RAUCH (KS)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:RAUCH
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:KS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4816 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1585
Mailing Address - Country:US
Mailing Address - Phone:888-265-1068
Mailing Address - Fax:
Practice Address - Street 1:6955 S UNION PARK CTR STE 400
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84047-4192
Practice Address - Country:US
Practice Address - Phone:888-265-1068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105574235Z00000X
KS2243235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist