Maryellen Glennon, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP1395 Issued in AZ

Practice address

240 W Thomas Rd
Phoenix, AZ 85013-4407

Phone

(602) 406-3000

NPI assigned

Apr 20, 2009

Last updated

Apr 20, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1184868242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3562 N TIROL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852154216",
            "telephone_number": "480-807-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134407",
            "telephone_number": "602-406-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENNON",
        "first_name": "MARYELLEN",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP1395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.