Basic Information
| Provider Information | |||||||||
| NPI: | 1144638883 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORYELL-LAPIERRE | ||||||||
| FirstName: | CALI | ||||||||
| MiddleName: | SUZANNE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21164 SAN MAR RD | ||||||||
| Address2: | |||||||||
| City: | BOONSBORO | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217131641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5403331744 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10435 DOWNSVILLE PIKE | ||||||||
| Address2: | |||||||||
| City: | HAGERSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217401732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017668222 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2014 | ||||||||
| LastUpdateDate: | 09/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 2202005399 | VA | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | SP 18588 | CA | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | 10345 | MD | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.