Provider Demographics
NPI:1477694941
Name:HERBICK, SEANNE (MED CCC-SLP)
Entity type:Individual
Prefix:
First Name:SEANNE
Middle Name:
Last Name:HERBICK
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 RICKSWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3029
Mailing Address - Country:US
Mailing Address - Phone:410-493-3170
Mailing Address - Fax:
Practice Address - Street 1:219 RICKSWOOD RD
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3029
Practice Address - Country:US
Practice Address - Phone:410-493-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02938235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist