Provider Demographics
NPI:1588071138
Name:AGUILERA, FERNANDA MARIEL (LICENTIATE)
Entity type:Individual
Prefix:
First Name:FERNANDA
Middle Name:MARIEL
Last Name:AGUILERA
Suffix:
Gender:F
Credentials:LICENTIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7512 HEATHERTON LN
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3231
Mailing Address - Country:US
Mailing Address - Phone:202-431-0370
Mailing Address - Fax:
Practice Address - Street 1:9801 GEORGIA AVE
Practice Address - Street 2:SUITE 229
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5276
Practice Address - Country:US
Practice Address - Phone:301-754-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant