Provider Demographics
NPI:1477946523
Name:MUCCHETTI, EMILY (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MUCCHETTI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ENTERPRISE PL STE 1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-8202
Mailing Address - Country:US
Mailing Address - Phone:302-678-3353
Mailing Address - Fax:302-678-9245
Practice Address - Street 1:100 ENTERPRISE PL STE 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-8202
Practice Address - Country:US
Practice Address - Phone:302-678-3353
Practice Address - Fax:302-678-9245
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0001511235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist