Provider Demographics
NPI:1639649924
Name:NAMOVICZ, KATY A (MS, MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATY
Middle Name:A
Last Name:NAMOVICZ
Suffix:
Gender:F
Credentials:MS, MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 MIDCOUNTY HWY
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-5100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8100 MIDCOUNTY HWY
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-5100
Practice Address - Country:US
Practice Address - Phone:301-947-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05578235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD05578OtherSTATE BOARD OF AUDIOLOGISTS, HEARING AID DISPENSERS & SPEECH-LANGUAGE PATHOLOGIS