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Organization

KIDS' VILLAGE THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANA CHERYL MASON M.A., SLP (SPEECH LANGUAGE PATHOLOGIST)
(443) 283-0618
Entity
Organization

Contact information

Practice address
5060 DORSEY HALL DR, SUITE 204, ELLICOTT CITY, MD 21042-7884
(443) 283-0618
(443) 283-0347
Mailing address
5060 DORSEY HALL DR, SUITE 204, ELLICOTT CITY, MD 21042-7884
(443) 283-0618
(443) 283-0347

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
09/25/2009
Last updated
09/25/2009
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