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General NPI Number Information
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NPI Number | 1245875533
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Entity Type | Organization
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Legal Business Name | ICAN SPEECH THERAPY, L.L.C.
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Dates
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Enumeration Date | 11/11/2019
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 1282 SMALLWOOD DR W # 191
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City | WALDORF
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State | MD
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Zip | 20603-4732
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Country | US
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Telephone | 301-263-7330
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Fax |
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Provider Business Mailing Address
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Address Line | 1282 SMALLWOOD DR W # 191
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City | WALDORF
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State | MD
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Zip | 20603-4732
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ARIA S. COOK
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Credential |
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Telephone | 443-687-6362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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