Healthcare Provider Details

I. General information

NPI: 1013964600
Provider Name (Legal Business Name): REBECCA MEASELL OWENS PHD, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19465 DEERFIELD AVE STE 201
LANSDOWNE VA
20176-1703
US

IV. Provider business mailing address

19465 DEERFIELD AVE STE 201
LANSDOWNE VA
20176-1703
US

V. Phone/Fax

Practice location:
  • Phone: 703-858-7620
  • Fax: 703-858-7657
Mailing address:
  • Phone: 703-858-7620
  • Fax: 703-858-7657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2201001244
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2101001483
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number2101001483
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: