Individual
LISA MUCCIOLI MCCLUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.CCC-SLP
Contact information
Practice address
247 HARRISON AVENUE, MORGAN COUNTY BOARD OF EDUCATION, BERKELEY SPRINGS, WV 25411
(304) 258-2014
Mailing address
103 CHARITON ROAD, WINCHESTER, VA 22602
(504) 662-0280
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0808
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7403044000
—
WV
Enumeration date
12/08/2008
Last updated
12/08/2008
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