Provider Demographics
NPI:1417369927
Name:SCALZI, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SCALZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4990 BOILING BROOK PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2300
Mailing Address - Country:US
Mailing Address - Phone:301-770-2710
Mailing Address - Fax:301-668-7008
Practice Address - Street 1:4990 BOILING BROOK PKWY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2300
Practice Address - Country:US
Practice Address - Phone:301-770-2710
Practice Address - Fax:301-668-7008
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04032235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist