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General NPI Number Information
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NPI Number | 1336707579
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Entity Type | Individual
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Provider Name | ANGELICA M MUJICA
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Gender | Female
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 423 N MCLEAN BLVD
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City | WICHITA
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State | KS
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Zip | 67203-5964
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Country | US
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Telephone | 316-618-1252
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Fax | 316-869-2277
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Provider Business Mailing Address
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Address Line | 423 N MCLEAN BLVD
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City | WICHITA
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State | KS
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Zip | 67203-5964
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Country | US
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Telephone | 316-618-1252
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Fax | 316-869-2277
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 5391
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License Number State | KS
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Legacy Identifiers
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Identifier #1
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Identifier Code | SI3993
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Identifier Type | OTHER
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Identifier State | FL
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Identifier Issuer | DOH LICENSE
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | SI3993
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Identifier Type | OTHER
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Identifier State | FL
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Identifier Issuer | DOH LICENSE
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