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General NPI Number Information
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NPI Number | 1568153997
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Entity Type | Organization
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Legal Business Name | MARIGOLD SPEECH PATHOLOGY SERVICES, LLC
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 101 E MILWAUKEE ST STE 507
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City | JANESVILLE
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State | WI
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Zip | 53545-3004
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Country | US
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Telephone | 608-728-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E MILWAUKEE ST STE 507
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City | JANESVILLE
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State | WI
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Zip | 53545-3004
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Country | US
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Telephone | 608-728-2207
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Fax | 608-621-3804
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | OLIVIA RAE JONES
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Credential | CCC-SLP
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Telephone | 608-728-2207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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