Individual
MRS. KELLY AILEEN GOTTSCHALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2225 OLD EMMORTON RD STE 210, BEL AIR, MD 21015-6123
(410) 515-4900
(410) 515-0777
Mailing address
2225 OLD EMMORTON RD STE 210, BEL AIR, MD 21015-6123
(410) 515-4900
(410) 515-0777
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
03866
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419800000
—
MD
Enumeration date
01/21/2019
Last updated
01/22/2019
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