Individual
MICHAEL MASCOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
2213 ROUND HILL DR, VIRGINIA BEACH, VA 23464-8855
(757) 648-2520
Mailing address
2605 ARABIAN DR, VIRGINIA BEACH, VA 23456-8027
(251) 979-3119
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204000175
VA
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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