Individual
MARISA ANNE CHACALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6901 N CHARLES ST, TOWSON, MD 21204-3780
(410) 887-3575
Mailing address
6901 N CHARLES ST, TOWSON, MD 21204-3780
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
08188
MD
Other
Enumeration date
04/10/2019
Last updated
12/02/2021
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