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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

NPI Number 1720524598
LBN Legal business name PEDIATRIC SPEECH LAB
Authorized official QUINTINA BRISCOE - (SPEECH-LANGUAGE PATHOLOGIST/ OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/17/2017
Last updated 09/01/2022 - About 4 years ago
Identifiers
DC License # SLP000879
MD License # 08341
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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