Provider Demographics
NPI:1275861981
Name:EDGHILL, JUDITH ANN (MS CCC-SLP/A)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:EDGHILL
Suffix:
Gender:F
Credentials:MS CCC-SLP/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12405 NEWCASTLE FARM WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3162
Mailing Address - Country:US
Mailing Address - Phone:202-413-1769
Mailing Address - Fax:
Practice Address - Street 1:7420 MARLBORO PIKE
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-4343
Practice Address - Country:US
Practice Address - Phone:301-736-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist