| Doctor Name: | MRS. MARISA GLADYS VACCALLUZZO |
| NPI Number: | 1306197173 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, CCC-SLP |
| License Number: | 06486 |
| Business Practice Address: | 9801 Georgia Ave Ste 229 Silver Spring, MD - 209025276 |
| Business Phone Number: | 3017542200 |
| Business Fax Number: | |
| Mailing Address: | 7900 Declaration Ln, POTOMAC |
| State: | MD |
| Postal Code: | 208543710 |
| Phone Number: | 3014694824 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2012 |
| NPI Last Update Date: | 09/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 06486 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| 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 |