Individual
ALYSSA MARIE MACUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-4089
(706) 721-8623
Mailing address
100 HICKORY DALE DR, DOVER, DE 19901-1806
(302) 943-1475
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
SC
Other
Enumeration date
06/11/2018
Last updated
04/29/2024
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