Individual
MICKI COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12520 WOLFSVILLE RD, MYERSVILLE, MD 21773-9302
(240) 236-2250
Mailing address
12520 WOLFSVILLE RD, MYERSVILLE, MD 21773-9302
(240) 236-2250
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01951
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
541628100
—
MD
Enumeration date
12/11/2018
Last updated
12/11/2018
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