MEDICARE: COMMUNITY SPEECH THERAPY, INC.

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	261QH0700X	Hearing and Speech Clinic/Center	01932	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134424872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY SPEECH THERAPY, INC.

Provider Business Mailing Address
First Line	:	11240 COUNTRY CLUB RD
Second Line	:
City	:	NEW MARKET
State	:	MD
Zip	:	21774-6735
Country	:	US
Telephone Number	:	301-606-8278
Fax Number	:

Provider Business Practice Location Address
First Line	:	164 W MAIN ST
Second Line	:	SUITE A
City	:	NEW MARKET
State	:	MD
Zip	:	21774-6279
Country	:	US
Telephone Number	:	301-606-8278
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SPEECH-LANGUAGE PATHOLOGIST
Name	:	MRS. KIMBERLY LOPATKA
Credential	:	MA, CCC-SLP
Telephone Number	:	301-606-8278

Provider Enumeration Date	:	01/11/2011
Last Update Date	:	01/11/2011

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Directions to “COMMUNITY SPEECH THERAPY, INC. ” Practice Location

Language	Start Address	Practice Location

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