Provider Demographics
NPI:1992723761
Name:MUZZARELLI, ROBERT A (MA, CCC-A)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:MUZZARELLI
Suffix:
Gender:M
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 PRINCE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4939
Mailing Address - Country:US
Mailing Address - Phone:252-758-5621
Mailing Address - Fax:
Practice Address - Street 1:206 PRINCE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4939
Practice Address - Country:US
Practice Address - Phone:252-758-5621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC383231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist