Individual
KERRY I PUTTLITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1305 DARES BEACH RD, PRINCE FREDERICK, MD 20678
(443) 550-8406
Mailing address
1305 DARES BEACH RD, PRINCE FREDERICK, MD 20678-4208
(443) 550-8406
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
04505
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61779501
MD-COMMERCIAL NUMBER
—
Enumeration date
04/03/2007
Last updated
10/21/2021
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