Provider Demographics
NPI:1962077412
Name:MASURA, MARCY ANNE
Entity type:Individual
Prefix:
First Name:MARCY
Middle Name:ANNE
Last Name:MASURA
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 1:2202 N LOIS AVE APT 2524
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-2582
Mailing Address - Country:US
Mailing Address - Phone:941-468-0283
Mailing Address - Fax:
Practice Address - Street 1:2202 N LOIS AVE APT 2524
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-2582
Practice Address - Country:US
Practice Address - Phone:941-468-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist