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Organization
BLUE JELLYFISH LLC
Active
Organization
BLUE JELLYFISH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNE MOIRA HASTING M.S., CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(410) 733-1405
Entity
Organization
Contact information
Practice address
11241 SKILIFT CT UNIT A, COLUMBIA, MD 21044-3094
(410) 733-1405
Mailing address
5525 TWIN KNOLLS RD STE 325, COLUMBIA, MD 21045-3203
(410) 733-1405
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
06143
MD
Other
Enumeration date
03/15/2017
Last updated
03/17/2017
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