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General NPI Number Information
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NPI Number | 1295304111
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Entity Type | Individual
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Provider Name | MONICA LACEY NEWPORT M.A., CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 1750 E FAIRMOUNT AVE
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City | BALTIMORE
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State | MD
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Zip | 21231-1534
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Country | US
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Telephone | 443-923-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 N CHARLES ST APT 405
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City | BALTIMORE
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State | MD
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Zip | 21201-5678
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Country | US
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Telephone | 614-406-6234
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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 |
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License Number State |
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