Provider Demographics
NPI:1437302841
Name:ROZMARYN, JACLYN (MS CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:
Last Name:ROZMARYN
Suffix:
Gender:F
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 RESEARCH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3204
Mailing Address - Country:US
Mailing Address - Phone:301-424-5200
Mailing Address - Fax:301-424-8063
Practice Address - Street 1:2301 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3204
Practice Address - Country:US
Practice Address - Phone:301-424-5200
Practice Address - Fax:301-424-8063
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01111237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD098468Medicare UPIN