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Individual

MCKENNA NISHIMOTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-1870
Mailing address
334 S COLLINGTON AVE, BALTIMORE, MD 21231-2732
(808) 253-9143

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
02654L
MD

Other

Enumeration date
04/20/2023
Last updated
04/20/2023
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