Mary Julie Kieta

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

05423 Issued in MD

Practice address

10910 Clarksville Pike
Ellicott City, MD 21042-6106

Phone

(410) 880-5840

NPI assigned

Nov 14, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1780153304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6034 RIVER BIRCH CT",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761058",
            "telephone_number": "410-578-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10910 CLARKSVILLE PIKE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426106",
            "telephone_number": "410-880-5840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIETA",
        "first_name": "MARY",
        "middle_name": "JULIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.