Provider Demographics
NPI:1689352049
Name:MILSTEAD, CAMRYN ALANA
Entity type:Individual
Prefix:
First Name:CAMRYN
Middle Name:ALANA
Last Name:MILSTEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 BARN OWL CT
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20639-3922
Mailing Address - Country:US
Mailing Address - Phone:443-684-4270
Mailing Address - Fax:
Practice Address - Street 1:3776 PATUXENT RIVER RD
Practice Address - Street 2:
Practice Address - City:DAVIDSONVILLE
Practice Address - State:MD
Practice Address - Zip Code:21035-2419
Practice Address - Country:US
Practice Address - Phone:443-808-1218
Practice Address - Fax:443-308-2111
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00138L2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty