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NPI Code Detail

MEDICARE: MARILYN TONKIN-STICKLER CCC-SLP

MEDICARE: MARILYN TONKIN-STICKLER 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
1235Z00000XSpeech-Language Pathologist2202001867VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13822946OTHERVACIGNA PPO
211123OTHERVACARENET
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4259332OTHERVASOUTHERN HEALTH
5195246OTHERVABCBS
6271538OTHERVAALLIANCE NETWORK

General Provider Information

NPI Number : 1588771588
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN TONKIN-STICKLER CCC-SLP
Provider Business Mailing Address
First Line : 4202 HERMITAGE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23227-3755
Country : US
Telephone Number : 804-266-6699
Fax Number : 804-264-5988
Provider Business Practice Location Address
First Line : 4202 HERMITAGE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23227-3755
Country : US
Telephone Number : 804-266-6699
Fax Number : 804-264-5988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 07/08/2007

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Directions to “ MARILYN TONKIN-STICKLER CCC-SLP” Practice Location

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