Individual
AVIVA MICHELLE MATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6901 N CHARLES ST, TOWSON, MD 21204-3780
(717) 395-6247
Mailing address
6005 BAYWOOD AVE, BALTIMORE, MD 21209-4001
(717) 395-6247
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01969L
MD
235Z00000X
Speech-Language Pathologist
—
MD
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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