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General NPI Number Information
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NPI Number | 1891209094
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Entity Type | Organization
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Legal Business Name | DAVIS SPEECH AND LANGUAGE SERVICES, LLC
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Dates
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Enumeration Date | 11/27/2017
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Last Update Date | 11/27/2017
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Provider Practice Location Address
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Address Line | 10482 BALTIMORE AVE STE 215
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City | BELTSVILLE
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State | MD
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Zip | 20705-2321
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Country | US
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Telephone | 628-233-2311
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Fax |
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Provider Business Mailing Address
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Address Line | 10482 BALTIMORE AVE STE 215
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City | BELTSVILLE
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State | MD
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Zip | 20705-2321
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Country | US
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Telephone | 628-233-2311
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Fax |
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Authorized Official
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Title or Position | OWNER, SPEECH-LANGUAGE PATHOLOGIST
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Name | RODNEISHA CHANELLE DAVIS
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Credential | M.S., CCC-SLP
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Telephone | 628-233-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 08247
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License Number State | MD
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