Basic Information
| Provider Information | |||||||||
| NPI: | 1871681510 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SKIENDZIELEWSKI | ||||||||
| FirstName: | LAUREL | ||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2768 QUEENSBERRY DR | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206392320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104144791 | ||||||||
| FaxNumber: | 4104144765 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 HOSPITAL ROAD AND CALVERT PHYSICAL THERAPY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104144791 | ||||||||
| FaxNumber: | 4104144765 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 04996 | MD | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.