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Individual

LISA JURKIEWICZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1119 STATE ROUTE 3 N STE 201, GAMBRILLS, MD 21054-1788
(443) 808-1218
Mailing address
3776 PATUXENT RIVER RD, DAVIDSONVILLE, MD 21035-2419
(443) 808-1218

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
09365
MD
235Z00000X
Speech-Language Pathologist
2202007908
VA
235Z00000X
Speech-Language Pathologist
SLP001045
DC

Other

Enumeration date
06/24/2015
Last updated
12/08/2021
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