CHRISTINE MICKNICK (NPI# 1982016168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982016168 |
| Entity Type | Individual |
| Full Name | CHRISTINE MICKNICK |
| Credential | M.A., CCC-SLP |
| Practice Address |
14707 Gardner Rd Waldorf MD 20601-3812 |
| Practice Telephone | 2023695265 |
| Mailing Telephone | 2023695265 |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2014-05-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 04128 | MD | Speech, Language and Hearing Service Providers |
| Street Address |
14707 GARDNER RD |
| City | WALDORF |
| State | MD |
| Zip Code | 20601-3812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154960128 | Sarian Beverly Wilson | Nurse Practitioner | 2203 Kayhill Dr, Waldorf, MD 20601 | 2019-12-23 |
| 1447778055 | Macy Alexandra Forman | Pharmacist | 3061 Tecnology Place, Waldorf, MD 20601 | 2017-09-04 |
| 1922523919 | Gregoire Mcclain | Counselor | Pathways Inc 2670 Crain Hwy, Suite 409, Waldorf, MD 20601 | 2017-08-10 |
| 1477091866 | Lutisse Cooper | Home Health Aide | 2520 Breakwater Court, Waldorf, MD 20601 | 2017-02-06 |
| 1609321637 | Kierra Jordan | Counselor | 2255 Crain Hwy Ste 102, Waldorf, MD 20601 | 2016-08-19 |
| 1215286828 | Linda Kline-lau | Counselor | 2255 Crain Highway, Waldorf, MD 20601 | 2012-08-29 |
| 1205124609 | Marian E. Kirk | Physical Therapist | 2960 Technology Place, Suite 110, Waldorf, MD 20601 | 2011-07-19 |
| 1932345238 | Patient First Maryland Medical Group | Non-Pharmacy Dispensing Site | 2855 Crain Highway, Waldorf, MD 20601 | 2008-12-17 |
| 1720150741 | Marianna Jeanne Patente | Counselor | 2670 Crain Highway, Suite #401, Waldorf, MD 20601 | 2006-11-14 |
| 1407940968 | Harold J. Pincus | Dentist | 2955 Crain Hwy., Waldorf, MD 20601 | 2006-10-02 |
| Find all providers in zip 20601 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811404296 | Loni Berbaum | Speech-Language Pathologist | 4817 Elmley Pl Apt 315, Waldorf, MD 20602 | 2018-01-06 |
| 1720524598 | Pediatric Speech Lab | Speech-Language Pathologist | 2547 Enterprise Pl, Waldorf, MD 20601-4953 | 2017-01-17 |
| 1649603424 | Lauren Ashley White | Speech-Language Pathologist | 10810 Winchester Street Apt127, Waldorf, MD 20603 | 2013-08-15 |
| 1427377548 | Southern Maryland Speech and Language Services | Speech-Language Pathologist | 3270 Elsa Ave, Waldorf, MD 20603-4048 | 2010-05-28 |
| 1952544801 | Tanya Lynnette Fulton | Speech-Language Pathologist | 8213 Seven Pines Ln, Waldorf, MD 20603-4062 | 2009-04-08 |
| 1215101399 | Child & Adult Rehab Serv Inc | Speech-Language Pathologist | 85 High Street, Suite 7, Waldorf, MD 20602-2150 | 2008-04-18 |
| 1073738944 | Karen Zimmerman | Speech-Language Pathologist | 10851 Constitution Dr, Waldorf, MD 20603-3949 | 2007-04-16 |
| 1558960831 | Kourtney Wathen | Speech-Language Pathologist | 3 Post Office Rd, Waldorf, MD 20602-2756 | 2020-10-19 |
| 1851829014 | Premium Communication Services, Inc. | Speech-Language Pathologist | 3261 Old Washington Rd Ste 2020, Waldorf, MD 20602-3231 | 2017-05-31 |
| 1831626308 | Erin Burris Gaumer | Speech-Language Pathologist | 4140 Old Washington Rd, Waldorf, MD 20602-3221 | 2017-05-16 |
| Find all providers in WALDORF | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.