Individual
AVIVA HEINEMANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7219 SCOTTS LEVEL ROAD, BALTIMORE, MD 21208
(410) 521-3600
Mailing address
6520 PEBBLE BROOKE RD, BALTIMORE, MD 21209-3857
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
05391
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033524186
—
MD
Enumeration date
02/20/2023
Last updated
02/20/2023
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