Provider Demographics
NPI:1447455761
Name:MARSHALL, FELICITY (SLP)
Entity type:Individual
Prefix:
First Name:FELICITY
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1543 HAGLEY RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-2260
Mailing Address - Country:US
Mailing Address - Phone:419-360-3005
Mailing Address - Fax:
Practice Address - Street 1:110 ARCO DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-2960
Practice Address - Country:US
Practice Address - Phone:419-865-7487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP8512235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2208864Medicaid
OH2208864Medicaid