Mucklow, Mary Beth

Mucklow, Mary Beth is an individual health care provider with primary practice located at 108 W Daisy Ln , New Albany IN 47150-4537. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Otolaryngology, Speech, Language and Hearing Service Providers / Audiologist. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Mucklow, Mary Beth can be contacted via phone (502) 893-0159.

Contact Information

Primary practice address
108 W Daisy Ln New Albany IN 47150-4537
Phone: (502) 893-0159
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0520 Kentucky
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 0520 Kentucky
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 23002305A Indiana

Profile Details

NPI number 1720257124
LBN Legal business name Mucklow, Mary Beth
Credentials AUD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 29th, 2008
Last updated Nov 15th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720257124 NPPES
Indiana MEDICAID 200937310

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