Provider Demographics
NPI:1942696927
Name:KUSMIN, CATHERINE ANN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:KUSMIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ANN
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:17620 REDLAND RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-1245
Mailing Address - Country:US
Mailing Address - Phone:301-869-7505
Mailing Address - Fax:301-869-7515
Practice Address - Street 1:17620 REDLAND RD STE A
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-1245
Practice Address - Country:US
Practice Address - Phone:301-869-7505
Practice Address - Fax:301-869-7515
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02689235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist