MEDICARE: ANNE-MARIE CASANOVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	06680	MD

General Provider Information

NPI Number	:	1225509540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE-MARIE CASANOVA

Provider Business Mailing Address
First Line	:	12806 FLETCHERTOWN RD
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-4535
Country	:	US
Telephone Number	:	301-641-4842
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 NALLEY TER
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-4434
Country	:	US
Telephone Number	:	301-618-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2018
Last Update Date	:	12/14/2018

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Directions to “ ANNE-MARIE CASANOVA ” Practice Location

Language	Start Address	Practice Location

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