Provider Demographics
NPI:1447522412
Name:WURIE, KRISTIN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:WURIE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9440 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3659
Mailing Address - Country:US
Mailing Address - Phone:301-297-4022
Mailing Address - Fax:301-297-4050
Practice Address - Street 1:9440 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3659
Practice Address - Country:US
Practice Address - Phone:301-297-4022
Practice Address - Fax:301-297-4050
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07165235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist