Healthcare Provider Details

I. General information

NPI: 1235041963
Provider Name (Legal Business Name): SAVINI PERERA CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KURUNAGE SAVINI NICOLA PERERA

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 ANNAPOLIS RD STE C
ODENTON MD
21113-1398
US

IV. Provider business mailing address

1202 ANNAPOLIS RD STE C
ODENTON MD
21113-1398
US

V. Phone/Fax

Practice location:
  • Phone: 410-305-4837
  • Fax:
Mailing address:
  • Phone: 410-305-4837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number11986
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: