Individual
KELLY GRACE MUCKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
11201 PEPPER RD, HUNT VALLEY, MD 21031-1201
(410) 527-9505
Mailing address
268 BARBERRY LN, LAYTONSVILLE, MD 20882-1945
(301) 641-5201
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
09359
MD
Other
Enumeration date
07/16/2020
Last updated
03/05/2021
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