Individual
MARISSA BODNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
201 BOOTH ST, ELKTON, MD 21921-5618
(410) 996-5450
Mailing address
520 NORTH ST, ELKTON, MD 21921-5610
(724) 972-3467
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
08837
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497223010
—
MD
Enumeration date
11/13/2018
Last updated
01/26/2023
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