Provider Demographics
NPI:1891268470
Name:CONDON, MARGARET EILEEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:EILEEN
Last Name:CONDON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10910 CLARKSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-6106
Mailing Address - Country:US
Mailing Address - Phone:410-313-6600
Mailing Address - Fax:
Practice Address - Street 1:14025 BURNTWOODS RD
Practice Address - Street 2:
Practice Address - City:GLENELG
Practice Address - State:MD
Practice Address - Zip Code:21737-9799
Practice Address - Country:US
Practice Address - Phone:410-313-5528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02353235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01110961OtherAMERICAN SPEECHLANGUAGEHEARING ASSOCIATION
MD02353OtherMARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE, BOARD OF EXAMINERS FOR AUDIOLI