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General NPI Number Information
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NPI Number | 1598806853
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Entity Type | Individual
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Provider Name | MARILYN THERESA CROWDER-WILE MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2746 SUPERIOR DR NW SUITE 300
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City | ROCHESTER
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State | MN
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Zip | 55901-8343
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Country | US
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Telephone | 507-288-0064
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Fax | 507-288-3993
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Provider Business Mailing Address
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Address Line | 4104 7TH PL NW
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City | ROCHESTER
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State | MN
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Zip | 55901-8454
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Country | US
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Telephone | 507-281-3001
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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 | 6018
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License Number State | MN
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