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Individual

MRS. TATEVIK ANANYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14409 GREENVIEW DR STE 102, LAUREL, MD 20708-4213
(301) 498-8100
(301) 498-0009
Mailing address
22 GLENBROOK RD, HICKSVILLE, NY 11801-4834
(917) 900-8474

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
02436L
MD
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02436L
MARYLAND DEPARTMENT OF HEALTH
MD
01
032706
NEW YORK STATE EDUCATION DEPARTMENT
NY
Enumeration date
08/18/2021
Last updated
02/02/2023
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