MEDICARE: HELENA O. JAREB PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TB0200X	Cognitive & Behavioral Psychologist	03921	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K840 0001	OTHER	MD	BCBS PROVIDER #
2	710A HO	OTHER	MD	BCBS MD RENDERING #

General Provider Information

NPI Number	:	1124248810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELENA O. JAREB PH.D.

Provider Business Mailing Address
First Line	:	8830 CAMERON CT
Second Line	:	SUITE 503
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4114
Country	:	US
Telephone Number	:	301-588-5565
Fax Number	:

Provider Business Practice Location Address
First Line	:	8830 CAMERON CT
Second Line	:	SUITE 503
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4114
Country	:	US
Telephone Number	:	301-588-5565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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