Provider Demographics
NPI:1144790502
Name:STUMP, ANNE KRISTINA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:KRISTINA
Last Name:STUMP
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4123 TOTTENHAM ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 W FREDERICK ST
Practice Address - Street 2:
Practice Address - City:WALKERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21793-8244
Practice Address - Country:US
Practice Address - Phone:404-545-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist