| Doctor Name: | DR. IANESSA ALICIA HUMBERT |
| NPI Number: | 1013152560 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 04974 |
| Business Practice Address: | 98 N Broadway Suite 413 Baltimore, MD - 212311536 |
| Business Phone Number: | 4105024458 |
| Business Fax Number: | 4105023546 |
| Mailing Address: | 98 N. Broadway, Suite 413, Dept Pm&r BALTIMORE |
| State: | MD |
| Postal Code: | 21231 |
| Phone Number: | 4105024458 |
| Fax Number: | |
| NPI Enumeration Date: | 12/12/2008 |
| NPI Last Update Date: | 12/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 04974 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |