Provider Demographics
NPI:1407086689
Name:CLEARSPEECH SPEECH AND LANGUAGE
Entity Type:Organization
Organization Name:CLEARSPEECH SPEECH AND LANGUAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:SLP-CCC
Authorized Official - Phone:301-802-3859
Mailing Address - Street 1:4105 BRIGGS CHANEY RD
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1040
Mailing Address - Country:US
Mailing Address - Phone:301-802-3859
Mailing Address - Fax:
Practice Address - Street 1:10714 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2112
Practice Address - Country:US
Practice Address - Phone:240-542-4420
Practice Address - Fax:240-542-4434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03681235Z00000X, 261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Multi-Specialty