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General NPI Number Information
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NPI Number | 1396573747
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Entity Type | Organization
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Legal Business Name | LISTEN, SPEAK AND COMMUNICATE SPEECH LANGUAGE PATHOLOGY
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 1587 BRIMFIELD CIR
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City | SYKESVILLE
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State | MD
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Zip | 21784-5938
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Country | US
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Telephone | 443-545-6341
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Fax |
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Provider Business Mailing Address
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Address Line | 1587 BRIMFIELD CIR
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City | SYKESVILLE
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State | MD
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Zip | 21784-5938
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Country | US
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Telephone | 443-545-6341
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | KELLY E GWYNNE-ORS
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Credential | M.S. SLP
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Telephone | 443-545-6341
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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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