Healthcare Provider Details

I. General information

NPI: 1780509117
Provider Name (Legal Business Name): CAITLIN MCGUIRK
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2641 STRAWBERRY LAKE WAY
ODENTON MD
21113-3616
US

IV. Provider business mailing address

1506 AVENNEL WAY
CROFTON MD
21114-2550
US

V. Phone/Fax

Practice location:
  • Phone: 410-672-7591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number03328L
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: