Healthcare Provider Details

I. General information

NPI: 1194651828
Provider Name (Legal Business Name): PEYTON JANIE GOMES AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9225 MELLENBROOK RD
COLUMBIA MD
21045-1816
US

IV. Provider business mailing address

9225 MELLENBROOK RD
COLUMBIA MD
21045-1816
US

V. Phone/Fax

Practice location:
  • Phone: 301-351-1375
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: