Doctor Name: | MARY LOU FUSCO |
NPI Number: | 1003085028 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS/CCC/SLP |
License Number: | 0115 |
Business Practice Address: | 408 E B Saunders Way Clarksburg, WV - 263013712 |
Business Phone Number: | 3046246554 |
Business Fax Number: | 3046245223 |
Mailing Address: | Po Box 1370, CLARKSBURG |
State: | WV |
Postal Code: | 263021370 |
Phone Number: | 3046246554 |
Fax Number: | 3046245223 |
NPI Enumeration Date: | 02/23/2008 |
NPI Last Update Date: | 02/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0115 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |