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General NPI Number Information
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NPI Number | 1093105686
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Entity Type | Individual
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Provider Name | AMY INNERBICHLER SLP
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Gender | Male
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 2500 WALLINGTON WAY SUITE 103
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City | MARRIOTTSVILLE
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State | MD
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Zip | 21104
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Country | US
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Telephone | 410-442-9791
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 WALLINGTON WAY SUITE 103
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City | MARRIOTTSVILLE
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State | MD
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Zip | 21104-1505
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Country | US
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Telephone | 410-442-9791
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 04028
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 674374
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License Number State | MD
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