Provider Demographics
NPI:1023122769
Name:BASILI, ANNAMARIA GERMAINE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANNAMARIA
Middle Name:GERMAINE
Last Name:BASILI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANNAMARIA
Other - Middle Name:GERMAINE BASILI
Other - Last Name:ZONAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:400 GRIST MILL XING
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2321
Mailing Address - Country:US
Mailing Address - Phone:410-987-8353
Mailing Address - Fax:
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7000
Practice Address - Fax:410-605-7702
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00004235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist