Individual
MRS. MARISA GLADYS VACCALLUZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
9801 GEORGIA AVE STE 229, SILVER SPRING, MD 20902-5276
(301) 754-2200
Mailing address
7900 DECLARATION LN, POTOMAC, MD 20854-3710
(301) 469-4824
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
000514
DC
235Z00000X
Speech-Language Pathologist
06486
MD
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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