Healthcare Provider Details

I. General information

NPI: 1588879050
Provider Name (Legal Business Name): MARGO LOUISE VENKER MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 BALBOA BLVD STE 242
NORTHRIDGE CA
91325-3593
US

IV. Provider business mailing address

31 EMMA ROSE CT
SAINT CHARLES MO
63304-7036
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-2273
  • Fax: 818-357-2505
Mailing address:
  • Phone: 314-805-2825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number01724
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number16041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: