Provider Demographics
NPI:1730219056
Name:WARWICK, MARLA A (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:A
Last Name:WARWICK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4341 S 197TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-8232
Mailing Address - Country:US
Mailing Address - Phone:918-355-4610
Mailing Address - Fax:
Practice Address - Street 1:9 N WATER ST
Practice Address - Street 2:SUITE 107
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-2819
Practice Address - Country:US
Practice Address - Phone:918-224-5400
Practice Address - Fax:918-512-6443
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2642235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist