Provider Demographics
NPI:1447499835
Name:ATTEBERRY, MARLA JEAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:JEAN
Last Name:ATTEBERRY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16 PINYON JAY LN
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1750
Mailing Address - Country:US
Mailing Address - Phone:949-466-9595
Mailing Address - Fax:949-770-8760
Practice Address - Street 1:16 PINYON JAY LN
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-1750
Practice Address - Country:US
Practice Address - Phone:949-466-9595
Practice Address - Fax:949-770-8760
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8716235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist