Marilyn Cleary

Individual provider Active NPI Speech-Language Pathologist · Severn, MD

NPI 1104946334 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104946334
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
04251 (MD)
Practice address
334 Fairfield Dr
Severn, MD 21144-3459
Phone
(410) 519-8962
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
04251MDMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 04251 MD Yes

Addresses

Primary practice location

334 Fairfield Dr
Severn, MD 21144-3459

Mailing address

334 Fairfield Dr
Severn, MD 21144-3459

Other providers in Severn, MD

All providers in Severn, MD · Speech-Language Pathologist in Maryland

Sources for this page

Verify at the official NPI Registry.