Doctor Name: | MARY ANNE MACLELLAN |
NPI Number: | 1053440479 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC, SLP |
License Number: | SP4920 |
Business Practice Address: | 1595 Grand Ave Suite 110 San Marcos, CA - 920782450 |
Business Phone Number: | 7604711198 |
Business Fax Number: | 7604715657 |
Mailing Address: | 1595 Grand Ave, Suite 110 SAN MARCOS |
State: | CA |
Postal Code: | 920782450 |
Phone Number: | 7604711198 |
Fax Number: | 7604715657 |
NPI Enumeration Date: | 03/02/2007 |
NPI Last Update Date: | 07/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP4920 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |