Provider Demographics
NPI:1518128818
Name:ALBERTY, JOHN CALVIN JR (MS CCC SLP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CALVIN
Last Name:ALBERTY
Suffix:JR
Gender:M
Credentials:MS CCC SLP
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Mailing Address - Street 1:9912 GLENKIRK WAY
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2990
Mailing Address - Country:US
Mailing Address - Phone:301-325-7560
Mailing Address - Fax:301-576-8550
Practice Address - Street 1:9912 GLENKIRK WAY
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-2990
Practice Address - Country:US
Practice Address - Phone:301-325-7560
Practice Address - Fax:301-576-8550
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD05732235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist