Provider Demographics
NPI:1851199038
Name:MUGNANI HALLET, CAMILA
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:MUGNANI HALLET
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CAMILA
Other - Middle Name:
Other - Last Name:MUGNANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44 HILLCREST PARK
Mailing Address - Street 2:
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-2989
Mailing Address - Country:US
Mailing Address - Phone:857-272-3374
Mailing Address - Fax:
Practice Address - Street 1:2040 BOSTON RD STE 18
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1385
Practice Address - Country:US
Practice Address - Phone:857-272-3374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPSLP10040235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist