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NPI Code Detail

MEDICARE: YITTEL BRACHA NOVICE MCD CCC SLP

MEDICARE: YITTEL BRACHA NOVICE MCD CCC 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
1235Z00000XSpeech-Language Pathologist08066MD

General Provider Information

NPI Number : 1366953580
Entity Type Code : Individual
Provider Name (Legal Business Name) : YITTEL BRACHA NOVICE MCD CCC SLP
Provider Business Mailing Address
First Line : 711 ACADEMY RD
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-1802
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 711 ACADEMY RD
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-1802
Country : US
Telephone Number : 410-788-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2017
Last Update Date : 10/15/2017

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