Provider Demographics
NPI:1306966023
Name:MUCHA, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MUCHA
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 1:961 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18444-7119
Mailing Address - Country:US
Mailing Address - Phone:570-470-6560
Mailing Address - Fax:
Practice Address - Street 1:961 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:MADISON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18444-7119
Practice Address - Country:US
Practice Address - Phone:570-470-6560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006351L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist