Provider Demographics
NPI:1780366435
Name:O'MAILLE, AIDAN JOSEPH (SLPA)
Entity type:Individual
Prefix:
First Name:AIDAN
Middle Name:JOSEPH
Last Name:O'MAILLE
Suffix:
Gender:M
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9126 CHARTERHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7327
Mailing Address - Country:US
Mailing Address - Phone:301-401-2689
Mailing Address - Fax:
Practice Address - Street 1:7090 SAMUEL MORSE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3442
Practice Address - Country:US
Practice Address - Phone:855-910-6147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant