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General NPI Number Information
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NPI Number | 1811622012
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Entity Type | Individual
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Provider Name | KYLIE MARSHALL MSSLP-CFY
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Gender | Female
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Dates
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Enumeration Date | 07/21/2022
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 585 OH-741
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City | LEBANON
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State | OH
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Zip | 45036
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Country | US
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Telephone | 513-932-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 10789 US 22
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City | CLARKSVILLE
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State | OH
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Zip | 45113-1102
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Country | US
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Telephone | 513-833-7799
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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 | SP.14987
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License Number State | OH
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