Provider Demographics
NPI:1407415409
Name:TAWEEL DAVIES, JUSTINE AMELIA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:AMELIA
Last Name:TAWEEL DAVIES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:JUSTINE
Other - Middle Name:AMELIA
Other - Last Name:TAWEEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:850 HUNGERFORD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1718
Mailing Address - Country:US
Mailing Address - Phone:240-740-1420
Mailing Address - Fax:
Practice Address - Street 1:13611 ROBEY RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4829
Practice Address - Country:US
Practice Address - Phone:240-740-1420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07054235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist