Individual
MARYLEN AGBANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
146 MACARTHUR BLVD, BUZZARDS BAY, MA 02532-3902
(508) 759-8880
Mailing address
2614 TAHITI ISLE AVE, NORTH LAS VEGAS, NV 89031-0998
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1129-SLP
SD
235Z00000X
Speech-Language Pathologist
22008037A
IN
235Z00000X
Speech-Language Pathologist
Primary
78579
MA
235Z00000X
Speech-Language Pathologist
LL61400870
WA
235Z00000X
Speech-Language Pathologist
SP-1992
NV
Other
Enumeration date
11/02/2022
Last updated
05/05/2023
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