Provider Demographics
NPI:1114313996
Name:MANSBACH, HALLIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:HALLIE
Middle Name:
Last Name:MANSBACH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 RICKOVER RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2331
Mailing Address - Country:US
Mailing Address - Phone:609-304-9345
Mailing Address - Fax:
Practice Address - Street 1:4954 N PALMER RD RM 5545
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-8100
Practice Address - Country:US
Practice Address - Phone:301-319-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01269237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter