Healthcare Provider Details

I. General information

NPI: 1851471973
Provider Name (Legal Business Name): MARLO BAILEY LAWRENCE AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARLO M. BAILEY AUD

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9723 MONTGOMERY RD
CINCINNATI OH
45242-7207
US

IV. Provider business mailing address

9723 MONTGOMERY RD
CINCINNATI OH
45242-7207
US

V. Phone/Fax

Practice location:
  • Phone: 513-675-8595
  • Fax: 513-793-9576
Mailing address:
  • Phone: 513-675-8595
  • Fax: 513-793-9576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA01360
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: