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Individual

SUSAN A. MARSHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., CCC-A

Contact information

Practice address
10094 LITZSINGER RD, SAINT LOUIS, MO 63124-1132
(636) 391-9622
(636) 391-9236
Mailing address
15825 MANCHESTER RD, SUITE 209, ELLISVILLE, MO 63011-2263
(636) 391-9622
(636) 391-9236

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
00833
MO
237700000X
Hearing Instrument Specialist
001124
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
333488211
MO
Enumeration date
07/02/2007
Last updated
02/24/2015
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