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General NPI Number Information
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NPI Number | 1194387498
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Entity Type | Organization
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Legal Business Name | SPOT FOR SPEECH AND OCCUPATIONAL INC.
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 8815 COLUMBIA 100 PKWY STE 4
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City | COLUMBIA
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State | MD
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Zip | 21045-2361
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Country | US
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Telephone | 877-776-8502
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Fax |
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Provider Business Mailing Address
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Address Line | 8815 COLUMBIA 100 PKWY STE 4
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City | COLUMBIA
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State | MD
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Zip | 21045-2361
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Country | US
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Telephone | 877-776-8502
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NICOLE ORELLANA
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Credential |
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Telephone | 877-776-8502
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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