Provider Demographics
NPI:1790786366
Name:DOY, CHARLOTTE R (MS, CCC/A)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:R
Last Name:DOY
Suffix:
Gender:F
Credentials:MS, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-6904
Mailing Address - Country:US
Mailing Address - Phone:410-760-8840
Mailing Address - Fax:
Practice Address - Street 1:203 HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-6904
Practice Address - Country:US
Practice Address - Phone:410-760-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00779231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD748900500Medicaid
MD748900500Medicaid
MDP33990Medicare UPIN