Provider Demographics
NPI:1487124293
Name:MATHEWS, ANN MARIE (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:ANN MARIE
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10084 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1621
Mailing Address - Country:US
Mailing Address - Phone:443-878-8755
Mailing Address - Fax:
Practice Address - Street 1:5610 CEDAR LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2737
Practice Address - Country:US
Practice Address - Phone:410-313-6907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05143235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist