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Individual

STEPHEN COLLALTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
14409 GREENVIEW DR STE 102, LAUREL, MD 20708-4213
(301) 498-8100
(301) 498-0009
Mailing address
PO BOX 500, BROOKEVILLE, MD 20833-0500
(301) 498-8100
(301) 498-0009

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
02459L
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02459L
MD DEPT OF HEALTH
MD
Enumeration date
05/20/2022
Last updated
05/20/2022
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