Mara Leah Haliczer, SLP
Individual provider Active NPI Speech-Language Pathologist · Saint Robert, MO
NPI 1336872811 · NPPES record last updated Jul 2, 2022
Key facts
- NPI
- 1336872811
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2022010152 (MO)
- Practice address
- 114 Liberty Pkwy Apt A10
Saint Robert, MO 65584-4875 - Phone
- (973) 508-9957
- NPI assigned
- Jul 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022010152 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2022010152 | MO | Yes |
Addresses
Primary practice location
114 Liberty Pkwy Apt A10
Saint Robert, MO 65584-4875
Mailing address
114 Liberty Pkwy Apt A10
Saint Robert, MO 65584-4875
Phone (973) 508-9957
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2022010152 | Other | MO | MISSOURI STATE BOARD - HEALING ARTS |
Other names
- Mara Katz
Other providers in Saint Robert, MO
- Destiny Jane Godfrey
- Jacqueline Gonzalez-Rivera
- Ainsley Brianna Graff
- Catherine J. Gray
- Matilda Moore Guetersloh
- Megan Hamilton
- Clayton Harmening
- Charles S. Harriman
- Heather Hatfield
- Jeremy Lee Hauret
All providers in Saint Robert, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.