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General NPI Number Information
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NPI Number | 1285179408
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Entity Type | Individual
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Provider Name | REBEKAH BURGESS WEYMES LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/23/2016
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Last Update Date | 12/23/2016
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Provider Practice Location Address
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Address Line | 202 COURSEVALL DR SUITE 101
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City | CENTREVILLE
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State | MD
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Zip | 21617-2804
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Country | US
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Telephone | 410-758-3303
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Fax |
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Provider Business Mailing Address
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Address Line | 24760 LOGANS WOODS DR
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City | DENTON
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State | MD
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Zip | 21629-2429
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Country | US
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Telephone | 410-253-2508
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 22343
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License Number State | MD
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