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General NPI Number Information
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NPI Number | 1598181638
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Entity Type | Individual
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Provider Name | CHRISTINA ANN CLAGETT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2014
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Last Update Date | 11/21/2018
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Provider Practice Location Address
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Address Line | 2470 LONGSTONE LN STE H
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City | MARRIOTTSVILLE
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State | MD
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Zip | 21104-1512
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Country | US
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Telephone | 410-442-8007
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Fax |
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Provider Business Mailing Address
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Address Line | 13760 TRIADELPHIA MILL RD
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1022
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Country | US
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Telephone | 301-641-6707
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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 | 06900
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License Number State | MD
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