Individual
MRS. TARA LYNNE GELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA., CCC-SLP
Contact information
Practice address
4605 TERRY DR, ELLICOTT CITY, MD 21043-6778
(410) 960-3291
Mailing address
4605 TERRY DR, ELLICOTT CITY, MD 21043-6778
(410) 960-3291
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
02536
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419800000
—
MD
Enumeration date
03/02/2007
Last updated
12/24/2020
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