MEDICARE: MRS. CARRIE ANN LOPANO MS, CCC-SLP

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	04424	MD

General Provider Information

NPI Number	:	1356814297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARRIE ANN LOPANO MS, CCC-SLP

Provider Business Mailing Address
First Line	:	1718 BEECHVIEW CT
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21015-5773
Country	:	US
Telephone Number	:	410-299-8163
Fax Number	:

Provider Business Practice Location Address
First Line	:	517 S FOUNTAIN GREEN RD
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21015-4717
Country	:	US
Telephone Number	:	410-638-4220
Fax Number	:

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

Provider Enumeration Date	:	01/03/2019
Last Update Date	:	01/03/2019

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