Provider Demographics
NPI:1205958550
Name:MSI, A PROFESSIONAL HEALTH STAFFING COMPANY
Entity type:Organization
Organization Name:MSI, A PROFESSIONAL HEALTH STAFFING COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-771-6868
Mailing Address - Street 1:224 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5432
Mailing Address - Country:US
Mailing Address - Phone:410-616-9303
Mailing Address - Fax:
Practice Address - Street 1:EXECUTIVE PLAZA 1 11350 MCCORMICK RD
Practice Address - Street 2:SUITE 503
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031
Practice Address - Country:US
Practice Address - Phone:410-771-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01908235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty