Provider Demographics
NPI:1598312316
Name:BALTIMORE CITY PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:BALTIMORE CITY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LUCINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:443-538-6033
Mailing Address - Street 1:1190 HARBOR TREE DR
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-1529
Mailing Address - Country:US
Mailing Address - Phone:443-538-6033
Mailing Address - Fax:
Practice Address - Street 1:200 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5984
Practice Address - Country:US
Practice Address - Phone:443-538-6033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1740586205Medicaid
MD1831757434Medicaid