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NPI Code Detail

MEDICARE: MS. MARY CHARLOTTE MILLER M.S.,CCC-SLP

MEDICARE: MS. MARY CHARLOTTE MILLER M.S.,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 Pathologist02624MD

General Provider Information

NPI Number : 1386874014
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY CHARLOTTE MILLER M.S.,CCC-SLP
Provider Business Mailing Address
First Line : 5439 FALLRIVER ROW CT
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-1909
Country : US
Telephone Number : 410-730-0255
Fax Number :
Provider Business Practice Location Address
First Line : 5439 FALLRIVER ROW CT
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-1909
Country : US
Telephone Number : 410-730-0255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2009
Last Update Date : 07/15/2009

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Directions to “ MS. MARY CHARLOTTE MILLER M.S.,CCC-SLP” Practice Location

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