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General NPI Number Information
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NPI Number | 1275861981
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Entity Type | Individual
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Provider Name | JUDITH ANN EDGHILL MS CCC-SLP/A
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Gender | Female
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 7420 MARLBORO PIKE
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City | FORESTVILLE
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State | MD
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Zip | 20747-4343
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Country | US
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Telephone | 301-736-0240
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Fax |
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Provider Business Mailing Address
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Address Line | 12405 NEWCASTLE FARM WAY
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-3162
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Country | US
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Telephone | 202-413-1769
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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 | 03313
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License Number State | MD
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