Provider Demographics
NPI:1871571380
Name:SCHORN-BELLOWS, MARILYN THERESE (AUD, CCC/A)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:THERESE
Last Name:SCHORN-BELLOWS
Suffix:
Gender:F
Credentials:AUD, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3629 ELEANORS TRCE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-3648
Mailing Address - Country:US
Mailing Address - Phone:770-534-8660
Mailing Address - Fax:
Practice Address - Street 1:250 JOHN W MORROW JR PKWY
Practice Address - Street 2:SUITE 113
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-8531
Practice Address - Country:US
Practice Address - Phone:770-532-5092
Practice Address - Fax:770-531-1865
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1240231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA64PCBGGMedicare ID - Type UnspecifiedAUDIOLOGY