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NPI Code Detail

MEDICARE: MRS. GAIL DOROTHY VANDERBEEK MS, CCC-SLP

MEDICARE: MRS. GAIL DOROTHY VANDERBEEK MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist02631MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
254541702OTHERMDCAREFIRST BCBS

General Provider Information

NPI Number : 1033248182
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GAIL DOROTHY VANDERBEEK MS, CCC-SLP
Provider Business Mailing Address
First Line : 2420 DERBY DRIVE
Second Line :
City : FALLSTON
State : MD
Zip : 21047
Country : US
Telephone Number : 410-692-2404
Fax Number :
Provider Business Practice Location Address
First Line : 6901 N CHARLES ST
Second Line :
City : TOWSON
State : MD
Zip : 21204-3780
Country : US
Telephone Number : 410-887-5121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 05/29/2020

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Directions to “ MRS. GAIL DOROTHY VANDERBEEK MS, CCC-SLP” Practice Location

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