Healthcare Provider Details

I. General information

NPI: 1568776045
Provider Name (Legal Business Name): PATRICIA PAINES ROSENBERG M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21030 FREDERICK RD, STE G #129
GERMANTOWN MD
20876-4133
US

IV. Provider business mailing address

21030 FREDERICK RD, STE G #129
GERMANTOWN MD
20876-4133
US

V. Phone/Fax

Practice location:
  • Phone: 301-540-4452
  • Fax: 301-540-4453
Mailing address:
  • Phone: 301-540-4452
  • Fax: 301-540-4453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number02526
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: