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General NPI Number Information
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NPI Number | 1639210073
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Entity Type | Individual
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Provider Name | JUDITH E HAYNOS M.S,CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 N WOLFE ST MEYER 2-109
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City | BALTIMORE
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State | MD
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Zip | 21287-0005
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Country | US
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Telephone | 443-287-3427
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Fax | 410-955-7885
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Provider Business Mailing Address
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Address Line | 106 W UNIVERSITY PKWY APT J2
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City | BALTIMORE
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State | MD
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Zip | 21210-3432
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Country | US
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Telephone | 443-799-5226
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Fax | 410-955-7885
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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 | 4100
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License Number State | MD
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