MEDICARE: DR. MONICA LEONIE MEERBAUM 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	103TC0700X	Clinical Psychologist	01518	MD

General Provider Information

NPI Number	:	1558483073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONICA LEONIE MEERBAUM PH.D.

Provider Business Mailing Address
First Line	:	4915 SAINT ELMO AVE
Second Line	:	SUITE 404
City	:	BETHESDA
State	:	MD
Zip	:	20814-6019
Country	:	US
Telephone Number	:	301-587-6211
Fax Number	:	301-986-0104

Provider Business Practice Location Address
First Line	:	4915 SAINT ELMO AVE
Second Line	:	SUITE 404
City	:	BETHESDA
State	:	MD
Zip	:	20814-6019
Country	:	US
Telephone Number	:	301-587-6211
Fax Number	:	301-986-0104

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	11/13/2015

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