National Provider Identifier

Marilyn K Aiwanse, MS, CCC-SLP

Marilyn K Aiwanse, MS, CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Fairport, NY and a listed phone number of (585) 249-7094.

NPI 1356079545Fairport, NYSpeech-Language Pathologist

Profile Overview

NPI
1356079545
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
August 15, 2022
Last Updated
May 06, 2025

Practice Location

  • 41 Oconnor RD
  • Fairport, NY 14450-1327

Phone: (585) 249-7094

Specialties

  • Speech-Language Pathologist (235Z00000X)

Endpoints

  • mbuck@daystarkids.org

    Direct Messaging Address | Daystar Kids | Rochester, NY 14618

    Email

Full Record
NPI
1356079545
Entity Type
Individual
Last Name
Aiwanse
First Name
Marilyn
Middle Name
K
Credential
MS, CCC-SLP
Provider Other Last Name
Buck
Provider Other First Name
Marilyn
Provider Other Middle Name
K
Provider Other Credential Text
MS, CCC-SLP
Provider Other Last Name Type Code
1
Mailing Street Address
41 Oconnor RD
Mailing City
Fairport
Mailing State
NY
Mailing ZIP Code
14450-1327
Mailing Country
US
Mailing Phone
(585) 249-7094
Practice Street Address
41 Oconnor RD
Practice City
Fairport
Practice State
NY
Practice ZIP Code
14450-1327
Practice Country
US
Practice Phone
(585) 249-7094
Enumeration Date
August 15, 2022
Last Updated
May 06, 2025
Sex
Female
Sole Proprietor
No
Certification Date
May 06, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)