Provider Demographics
NPI:1750124905
Name:MAGTOTO, MICA (MA,CF-SLP)
Entity type:Individual
Prefix:
First Name:MICA
Middle Name:
Last Name:MAGTOTO
Suffix:
Gender:F
Credentials:MA,CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 24TH ST
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4834
Mailing Address - Country:US
Mailing Address - Phone:515-817-3447
Mailing Address - Fax:
Practice Address - Street 1:707 E 5TH ST APT 6
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-5429
Practice Address - Country:US
Practice Address - Phone:515-817-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist