Provider Demographics
NPI:1548550734
Name:MIHALYI, MARY ELLEN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELLEN
Last Name:MIHALYI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 CIRCLE AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4834
Mailing Address - Country:US
Mailing Address - Phone:301-270-6949
Mailing Address - Fax:
Practice Address - Street 1:317 CIRCLE AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4834
Practice Address - Country:US
Practice Address - Phone:301-270-6949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-09
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP000078235Z00000X
MD05614235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist