Provider Demographics
NPI:1306316260
Name:CIMINO, ROSEANN EILEEN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ROSEANN
Middle Name:EILEEN
Last Name:CIMINO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:ROSEANN
Other - Middle Name:EILEEN
Other - Last Name:CIMINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:1901 FALLSTON RD
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-1418
Mailing Address - Country:US
Mailing Address - Phone:410-638-4190
Mailing Address - Fax:
Practice Address - Street 1:1901 FALLSTON RD
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-1418
Practice Address - Country:US
Practice Address - Phone:410-638-4190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05651235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist