MEDICARE: CARLEY M ENS

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	02438L	MD

General Provider Information

NPI Number	:	1215653597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLEY M ENS

Provider Business Mailing Address
First Line	:	2 E JOPPA RD APT 203
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-3142
Country	:	US
Telephone Number	:	732-768-9118
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 E FORT AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-5215
Country	:	US
Telephone Number	:	410-396-1503
Fax Number	:

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

Provider Enumeration Date	:	10/18/2022
Last Update Date	:	10/18/2022

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Directions to “ CARLEY M ENS ” Practice Location

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