MEDICARE: MARILYN MUNKER MS, CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	SP-683	NV

General Provider Information

NPI Number	:	1164899126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN MUNKER MS, CCC-SLP

Provider Business Mailing Address
First Line	:	123 MOUNT ROSE ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-3419
Country	:	US
Telephone Number	:	775-240-0667
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 MOUNT ROSE ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-3419
Country	:	US
Telephone Number	:	775-240-0667
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2015
Last Update Date	:	08/25/2015

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Directions to “ MARILYN MUNKER MS, CCC-SLP” Practice Location

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