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NPI Code Detail

MEDICARE: LILLIE H MARINO

MEDICARE: LILLIE H MARINO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1043144207
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILLIE H MARINO
Provider Business Mailing Address
First Line : 5117 FRIENDLY BAPTIST CH RD
Second Line :
City : INDIAN TRAIL
State : NC
Zip : 28079-7794
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 FULLWOOD RD
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-2659
Country : US
Telephone Number : 704-841-4920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

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Directions to “ LILLIE H MARINO ” Practice Location

Language Start Address Practice Location
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