Healthcare Provider Details

I. General information

NPI: 1750095006
Provider Name (Legal Business Name): TEHILA TRAUB RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 REISTERSTOWN RD STE 22
BALTIMORE MD
21208-1388
US

IV. Provider business mailing address

1777 REISTERSTOWN ROAD SUITE 22, PO BOX 350
BALTIMORE MD
21203-0305
US

V. Phone/Fax

Practice location:
  • Phone: 410-415-3875
  • Fax:
Mailing address:
  • Phone: 410-415-3875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX6458
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: