Basic Information
| Provider Information | |||||||||
| NPI: | 1053061960 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LOVETOLEARNMD, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1204 ADGATE CT | ||||||||
| Address2: | |||||||||
| City: | WOODBINE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217978623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017855334 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1204 ADGATE CT | ||||||||
| Address2: | |||||||||
| City: | WOODBINE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217978623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017855334 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2022 | ||||||||
| LastUpdateDate: | 03/24/2022 | ||||||||
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| AuthorizedOfficialLastName: | FERNANDEZ | ||||||||
| AuthorizedOfficialFirstName: | MACARENA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER, SLP/BCBA | ||||||||
| AuthorizedOfficialTelephone: | 3017855334 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MA CCC-SLP/BCBA | ||||||||
| NPICertificationDate: | 03/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 252Y00000X | N | Agencies | Early Intervention Provider Agency | 103K00000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst | 235Z00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.