Provider Demographics
NPI:1750848677
Name:KELLINGER, DENISE LITRENTA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LITRENTA
Last Name:KELLINGER
Suffix:
Gender:F
Credentials: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 1:6474 PARK FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5856
Mailing Address - Country:US
Mailing Address - Phone:410-404-4243
Mailing Address - Fax:
Practice Address - Street 1:5215 W RUNNING BROOK RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-1741
Practice Address - Country:US
Practice Address - Phone:410-313-6893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1045235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist