Healthcare Provider Details

I. General information

NPI: 1982245924
Provider Name (Legal Business Name): ALLISON MARIE BLACKMON AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON MARIE HEUBER

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11119 ROCKVILLE PIKE STE 210
ROCKVILLE MD
20852-3200
US

IV. Provider business mailing address

11119 ROCKVILLE PIKE STE 210
ROCKVILLE MD
20852-3200
US

V. Phone/Fax

Practice location:
  • Phone: 301-468-3977
  • Fax: 301-468-3978
Mailing address:
  • Phone: 301-468-3977
  • Fax: 301-468-3978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1503
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01503
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: