Healthcare Provider Details

I. General information

NPI: 1467362673
Provider Name (Legal Business Name): MARY NICOLE ALDABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S FREDERICK AVE STE 101
GAITHERSBURG MD
20877-4151
US

IV. Provider business mailing address

10670 WEYMOUTH ST APT 204
BETHESDA MD
20814-4248
US

V. Phone/Fax

Practice location:
  • Phone: 347-944-7546
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number03416L
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: