Kerry Elisabeth Fitzpatrick, M.A. CCC-SLP

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

NPI 1861915837 · NPPES record last updated Jul 21, 2017

Key facts

NPI
1861915837
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
07437 (MD)
Practice address
4313 Green Glade Rd
Phoenix, MD 21131-1703
Phone
(410) 241-8304
NPI assigned
Jul 21, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
07437MDMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 07437 MD Yes

Addresses

Primary practice location

4313 Green Glade Rd
Phoenix, MD 21131-1703

Mailing address

4313 Green Glade Rd
Phoenix, MD 21131-1703

Other providers in Phoenix, MD

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

Sources for this page

Verify at the official NPI Registry.