Individual
MALORIE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
201 TALBOT BLVD, CHESTERTOWN, MD 21620-3000
(410) 778-8150
Mailing address
201 TALBOT BLVD, CHESTERTOWN, MD 21620-3000
(410) 778-8150
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
04059
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04059
STATE OF MD DEPARTMENT OF HEALTH AUD, HAD & SPEECH-LANG PATHOLOGISTS
MD
01
—
12010637
ASHA - AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
—
Enumeration date
12/03/2019
Last updated
12/03/2019
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