Healthcare Provider Details

I. General information

NPI: 1831419159
Provider Name (Legal Business Name): REBECCA ELIZABETH BOOK AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8028 RITCHIE HWY STE 136A
PASADENA MD
21122-1030
US

IV. Provider business mailing address

PO BOX 1680
CLARKSBURG MD
20871-1680
US

V. Phone/Fax

Practice location:
  • Phone: 410-590-9462
  • Fax: 410-590-9464
Mailing address:
  • Phone: 410-590-9462
  • Fax: 410-590-9464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number01194
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: