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NPI Code Detail

MEDICARE: MICHELLE MELEADY-D'AMBROSIO M.S.CCC-SLP

MEDICARE: MICHELLE MELEADY-D'AMBROSIO 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 Pathologist02369MD

General Provider Information

NPI Number : 1538637509
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MELEADY-D'AMBROSIO M.S.CCC-SLP
Provider Business Mailing Address
First Line : 15631 THISTLE DOWNS CT
Second Line :
City : WOODBINE
State : MD
Zip : 21797-8767
Country : US
Telephone Number : 240-938-6115
Fax Number :
Provider Business Practice Location Address
First Line : 4101 OLD NATIONAL PIKE
Second Line :
City : MOUNT AIRY
State : MD
Zip : 21771-4115
Country : US
Telephone Number : 301-829-0800
Fax Number : 301-698-4693
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2018
Last Update Date : 11/08/2018

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Directions to “ MICHELLE MELEADY-D'AMBROSIO M.S.CCC-SLP” Practice Location

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