Provider Demographics
NPI:1407317134
Name:JANKOVICH, MARIA (BS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:JANKOVICH
Suffix:
Gender:F
Credentials:BS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W DEER PARK RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1850
Mailing Address - Country:US
Mailing Address - Phone:301-284-4150
Mailing Address - Fax:
Practice Address - Street 1:101 W DEER PARK RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1850
Practice Address - Country:US
Practice Address - Phone:301-284-4150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist