Provider Demographics
NPI:1689430191
Name:CHILDRENS SPEECH AND LANGUAGE CENTER
Entity Type:Organization
Organization Name:CHILDRENS SPEECH AND LANGUAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALYSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:585-415-2590
Mailing Address - Street 1:772 EASTERN POINT RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-6945
Mailing Address - Country:US
Mailing Address - Phone:585-415-2590
Mailing Address - Fax:
Practice Address - Street 1:815 RITCHIE HWY STE 118
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4192
Practice Address - Country:US
Practice Address - Phone:410-975-5863
Practice Address - Fax:410-630-3857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty