MEDICARE: DR. JODI BETH RECHES AUD

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
1	231H00000X	Audiologist	00832	MD

General Provider Information

NPI Number	:	1558369405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JODI BETH RECHES AUD

Provider Business Mailing Address
First Line	:	6604 TROY COURT
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209
Country	:	US
Telephone Number	:	410-302-5830
Fax Number	:	410-764-1511

Provider Business Practice Location Address
First Line	:	6503 PARK HEIGHTS AVE
Second Line	:	SUITE LD
City	:	BALTIMORE
State	:	MD
Zip	:	21215
Country	:	US
Telephone Number	:	410-764-3113
Fax Number	:	410-764-1511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	07/08/2007

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