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General NPI Number Information
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NPI Number | 1518637032
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Entity Type | Individual
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Provider Name | MARILYN CHEN SLP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 401 SANTA FE WAY
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City | TEMPLE
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State | TX
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Zip | 76501-4251
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Country | US
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Telephone | 254-215-7064
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Fax |
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Provider Business Mailing Address
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Address Line | 2509 SPRINGWOOD LN
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City | GEORGETOWN
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State | TX
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Zip | 78628-2781
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Country | US
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Telephone |
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Fax |
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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 | 113111
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License Number State | TX
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