MEDICARE: MRS. CAROLYN DINATALE SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	02027	MD

General Provider Information

NPI Number	:	1043391865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLYN DINATALE SLP

Provider Business Mailing Address
First Line	:	6800 YOUNGSTOWN AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21222-1112
Country	:	US
Telephone Number	:	410-583-1515
Fax Number	:	410-583-2491

Provider Business Practice Location Address
First Line	:	1026 CROMWELL BRIDGE RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21286-3308
Country	:	US
Telephone Number	:	410-583-1515
Fax Number	:	410-583-2491

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/08/2007

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Directions to “ MRS. CAROLYN DINATALE SLP” Practice Location

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