Provider Demographics
NPI:1225274129
Name:OXFORD INTERNATIONAL TREATMENT AND WELLNESS CENTER FOR COMMUNICATION D
Entity Type:Organization
Organization Name:OXFORD INTERNATIONAL TREATMENT AND WELLNESS CENTER FOR COMMUNICATION D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDRIETTE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC-SLP
Authorized Official - Phone:443-604-2509
Mailing Address - Street 1:13521 NICHOLS DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1326
Mailing Address - Country:US
Mailing Address - Phone:443-604-2509
Mailing Address - Fax:301-854-0037
Practice Address - Street 1:13521 NICHOLS DRIVE
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1326
Practice Address - Country:US
Practice Address - Phone:443-604-2509
Practice Address - Fax:301-854-0037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD662877235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty