Healthcare Provider Details

I. General information

NPI: 1518897255
Provider Name (Legal Business Name): LAUREN NOWICKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 STATE ROUTE 3 N STE 201
GAMBRILLS MD
21054-1788
US

IV. Provider business mailing address

8203 ROYAL STAR CT
PASADENA MD
21122-3860
US

V. Phone/Fax

Practice location:
  • Phone: 443-808-1218
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: