Provider Demographics
NPI:1225711682
Name:DRURY, REBECCA (LGPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:DRURY
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 OELLA AVE
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4729
Mailing Address - Country:US
Mailing Address - Phone:240-643-5639
Mailing Address - Fax:
Practice Address - Street 1:10 W MADISON ST STE 11
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2313
Practice Address - Country:US
Practice Address - Phone:443-438-7863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14196101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional