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General NPI Number Information
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NPI Number | 1295718674
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Entity Type | Individual
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Provider Name | MARJORIE MEYER PALMER MA
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Gender | Female
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 08/28/2009
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Provider Practice Location Address
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Address Line | 3760 YALE WAY STE 1A
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City | FREMONT
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State | CA
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Zip | 94538-6157
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Country | US
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Telephone | 510-651-2285
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Fax | 831-623-9007
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Provider Business Mailing Address
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Address Line | 1528 MERRILL RD
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City | SAN JUAN BAUTISTA
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State | CA
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Zip | 95045-9629
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Country | US
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Telephone | 831-623-9007
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Fax | 831-623-9007
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP5478
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License Number State | CA
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