Provider Demographics
NPI:1679075485
Name:ACUNA, MARIA MARCELINA
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:MARCELINA
Last Name:ACUNA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:HENRIKSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:319 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-7029
Mailing Address - Country:US
Mailing Address - Phone:509-951-1409
Mailing Address - Fax:509-340-9942
Practice Address - Street 1:319 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-7029
Practice Address - Country:US
Practice Address - Phone:509-209-7429
Practice Address - Fax:509-340-9942
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-07
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL61169429235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist