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Contact Information

PEDIATRIC SPEECH LAB
11350 PEMBROOKE SQ STE 313
WALDORF, MD20603-4809
 Phone: 301-885-0033
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
 

Assistant Behavior Analyst

106E00000X
 

Behavior Analyst

103K00000X
 

Community/Behavioral Health

251S00000X
 

Multi-Specialty

261QM1300X 70 Clinic or Group Practice
Indicates primary specialty

NPI Profile & details for PEDIATRIC SPEECH LAB · (Female)

NPI Number 1720524598
Status Active
Credentials
Entity Individual
Enumeration date 01/17/2017
Last updated 09/01/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • DC License # SLP000879
  • MD License # 08341
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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