Organization
OHIO UNIVERSITY
Active
Other names
Ohio University Therapy Assoc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIANNE S MALAWISTA PHD,MA ,CCC-SLP (COORDINATOR OF CLINICAL SERVICES)
(740) 593-1404
Entity
Organization
Contact information
Practice address
W174 GROVER CENTER, ATHENS, OH 45701
(740) 593-1404
(740) 593-4433
Mailing address
W174 GROVER CENTER, ATHENS, OH 45701
(740) 593-1404
(740) 593-4433
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
231H00000X
Audiologist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
OH
237600000X
Audiologist-Hearing Aid Fitter
A01437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000246469
ANTHEM
OH
05
—
0624471
—
OH
Enumeration date
04/09/2007
Last updated
07/17/2013
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