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NPI Code Detail

MEDICARE: LISA MADOFF TOWNSEND

MEDICARE:   LISA MADOFF TOWNSEND
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 Pathologist07959MD

General Provider Information

NPI Number : 1487128542
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MADOFF TOWNSEND
Provider Business Mailing Address
First Line : 10910 CLARKSVILLE PIKE
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-6106
Country : US
Telephone Number : 410-313-6600
Fax Number :
Provider Business Practice Location Address
First Line : 12500 FREDERICK RD
Second Line :
City : WEST FRIENDSHIP
State : MD
Zip : 21794-9509
Country : US
Telephone Number : 410-313-5512
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2019
Last Update Date : 01/11/2019

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Directions to “ LISA MADOFF TOWNSEND ” Practice Location

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