Provider Demographics
NPI:1194173229
Name:MURPHY, MARY KATHERINE (MS, CCC-SLP/L)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:KATHERINE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:KATHERINE
Other - Last Name:JACOBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:PSC 78 BOX 2053
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96326-0021
Mailing Address - Country:US
Mailing Address - Phone:702-183-8390
Mailing Address - Fax:
Practice Address - Street 1:PSC 78 BOX 2053
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96326-0021
Practice Address - Country:US
Practice Address - Phone:315-225-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P8988235Z00000X
HISP-2279235Z00000X
ARSP4151235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist