Provider Demographics
NPI:1710605373
Name:MUSSO, CARMEN MARIA
Entity type:Individual
Prefix:MISS
First Name:CARMEN
Middle Name:MARIA
Last Name:MUSSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 JAMES MADISON HWY
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-2362
Mailing Address - Country:US
Mailing Address - Phone:540-825-3677
Mailing Address - Fax:
Practice Address - Street 1:471 JAMES MADISON HWY
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-2362
Practice Address - Country:US
Practice Address - Phone:540-825-3677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000968235Z00000X
VA2202011043235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist