Individual
MRS. ANGIE MCLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
4981 ILCHESTER RD, ELLICOTT CITY, MD 21043-6837
(410) 313-2524
Mailing address
10910 CLARKSVILLE PIKE, ELLICOTT CITY, MD 21042-6106
(410) 313-2524
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
03204
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03204
LICENCE
MD
Enumeration date
11/19/2018
Last updated
12/20/2018
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